Barriers to smoking cessation in pregnancy: a qualitative study

The magnitude of smoking as a public health concern in Britain is reflected in the recent government investment to develop smoking cessation services. Smoking in pregnancy is a priority. This article presents the findings of a small qualitative research study exploring barriers to pregnant women stopping smoking. The research was conducted in deprived areas of South Yorkshire, with levels of smoking-related ill health higher than the national average. The study participants revealed a belief system resulting in a self-fulfilling prophecy of relapse or failure to quit. The role and meaning of smoking for women with a high caring burden and socio-economic problems resonate strongly with earlier studies. Other barriers were the influence of family and friends, how women interpreted facts relating to smoking risks and the nature of smoking cessation service delivery. Community nursing staff have a potential in the delivery of smoking cessation interventions. Effective training should be a priority.     

护理管理者对护理不良事件中第二受害者态度的质性研究

目的了解护理管理者对第二受害者的态度,为医疗机构形成对第二受害者的支持策略提供依据。方法采用质性研究方法,于2018年5月—8月选择某三级甲等医院9名护理管理者进行半结构式深入访谈,采用Colaizzi7步分析法收集整理资料,分析提炼主题。结果护理管理者对第二受害者认识不足;对护理不良事件是否应由第二受害者负责、是否需要追责和惩罚持不同意见;承认第二受害者承受心理压力,但人文关怀措施不足。结论护理管理者对第二受害者的态度并不理想,医疗机构及护理管理者应重视护理不良事件,针对原因制订相应的预防措施,减少和控制护理不良事件的发生,降低对第二受害者的伤害。     

Comparison of mental health nurses' attitudes towards smoking and smoking behaviour

Smoking is widely recognized as an important public health issue for the general population and in the mental health field where the rates are particularly high. Mental health nurses are well positioned to take an active role in encouraging and supporting people diagnosed with mental illness to cease smoking. Information about smoking behaviour and the attitudes of mental health nurses is necessary to develop strategies to prepare nurses for this important role. A cross‐sectional study was conducted to examine the smoking behaviour and attitudes of mental health nurses in Queensland, Australia, through a random selection of mental health nurses (n = 289). Smoking rates (16%) in this study were lower than those for the Australian population. Smokers were significantly (P < 0.001) less likely to agree that health‐care facilities should promote a healthy environment. All participants, but predominantly those who smoked (P < 0.001), supported the individual's right to smoke. Participants believed they possessed appropriate skills to deliver the antismoking message effectively, although stronger beliefs were characteristic of non‐smokers. Participants who smoked perceived that their smoking status assisted in facilitating interactions with consumers (P < 0.001). The findings have implications for the health promotion activities of mental health nurses.     

成都市区新生儿父母吸烟危害性知识及吸烟态度调查

[目的 ]了解新生儿父母对吸烟危害性知识的掌握程度以及对改变吸烟行为的态度 ,为制定减少婴幼儿家庭内被动吸烟的控烟计划提供依据。 [方法 ]采用整群抽样的方法 ,从成都市 4所妇产专科医院抽取 5 2 0户 10 40位新生儿父母进行问卷调查。[结果 ]新生儿父亲现在吸烟率为5 1.0 % ,现在吸烟者的居室内吸烟率为86.2 % ,新生儿父亲对 16项吸烟危害健康相关知识条目的平均知晓率为 64 .5 % ,新生儿母亲平均知晓率为 68.1%。新生儿母亲吸烟危害性知识水平高于新生儿父亲(P <0 .0 1)。 3 2 .8%的现在吸烟者在今后6个月内有戒烟打算 ,无戒烟打算的现在吸烟者中 ,78.8%的人表示今后会减少吸烟量 ,没有人表示今后在家中会当着婴幼儿的面吸烟 ,95 .8%新生儿母亲表示将干预丈夫的居室内吸烟行为。 [结论 ]孩子的出生可作为对吸烟者居室内吸烟行为进行干预的切入时点 ,应给予新生儿父母必要的知识、信念及技术支持 ,文化程度较低的人群应作为重点宣教人群。     

Asylum blues: staff attitudes towards psychiatric nursing in Sarawak, East Malaysia

This paper draws upon findings from an ethnographic study of psychiatric service users in a psychiatric institution in Sarawak, East Malaysia. Findings focus primarily on the accounts of nursing staff in relation to attitudes towards psychiatric work and patients. These indicate that despite a rhetoric of decentralized services, a custodial 'asylum' model continues to influence the care of patients at many levels. Negative professional attitudes towards patients lead to issues of both moral and physical containment. However, an associated attitude of stigma and prejudice towards mental illness impacts upon how attractive a career in psychiatric nursing is perceived to be by respondents, subject to gender differentials.     

Extracellular elastolytic activity in human lung lavage: a comparative study between smokers and non-smokers

Unrestrained proteolysis in the lung is believed to initiate emphysema, a disease common among tobacco smokers. However, few studies have found extracellular protease activity in human lung lavage. In this investigation, elastase and serine protease activities were measured in bronchoalveolar lavage supernatants (BAL) from patients undergoing routine investigations. Significantly more elastolytic activity (against insoluble [3H]-elastin) was recovered in the lavage of smokers than that of non-smokers. However, no significant difference was found when the levels of serine proteolytic activity (against N-succinyl-L-trialanyl-p-nitroanilide) were compared. The elastolytic component of the protease activity rose from 5% in non-smokers' BAL to over 30% in that of smokers, suggesting that elastase activity is selectively enhanced by smoking. In lavages from most smokers, 80% or more of the elastase activity was serine-dependent, whereas lavages from non-smokers contained variable proportions of serine elastase. Both alpha 1-proteinase inhibitor (alpha 1-PI) and a low molecular weight antiprotease, bronchial mucus proteinase inhibitor (BMPI) were detectable in the lavage samples, the latter contributing up to 76% of the total antiprotease quantified in the lavage. Functional antiprotease was detected in 85% of the lavages. Since there were no differences in either antiprotease levels or functional inhibitory capacities between lavages from smokers and controls, it is concluded that the imbalance in the protease/antiprotease profile of the smokers' lung results from an enhancement of proteases, specifically of elastolytic activity, rather than a reduction in inhibitory capacity.     

Smoking habits and attitudes towards smoking among university students in Jordan

The aim of this study was to estimate the prevalence of smoking and to describe the habits, attitudes, and practices related to smoking among students of Jordan University of Science and Technology (JUST), Irbid, Jordan.

Students (n=650) were recruited in randomly selected, cluster samples drawn from the medical and engineering colleges of JUST. They were made familiar with a modified Arabic version of the World Health Organisation Smoking Questionnaire and the Attitudes towards Smoking Questionnaire to study their habits, attitudes, and beliefs in relation to smoking.

The study revealed that the prevalence of smoking was 28.6% (50.2% among males and 6.5% among females). Friends, not family, were the main source of the first smoking, and this most often occurred after 15 years of age (82.3%). Males preferred smoking in the cafeteria, females in the bathroom. The main advantage of smoking for males was calming down, while for females it was independence. Non-smokers chose not to smoke because of health and hatred of the habit. The non-smokers had more positive attitudes against smoking and were more aware of the adverse effects of smoking. The reasons smokers gave for starting smoking were pleasure, followed by stress and curiosity. Two-thirds of smokers intended to quit smoking in the future. Some smokers disagreed with some criticisms against smoking, and reasons why they did not want to quit included social attitudes, addiction, and not knowing how to quit.

Results of this study may provide baseline data to develop an anti-smoking program in the university and encourage policy makers to limit smoking in the university by strengthening the policies against smoking.     

The negative attitudes of nurses towards older patients in the acute hospital setting: a qualitative descriptive study

AIM: This paper reports the findings of a sub-sample of interviews from a larger study designed to explore the attitudes of health care workers towards older people in that acute care setting.The discussion in this paper focuses only on interviews with nurses and their negative attitudes towards older people in their care. BACKGROUND: As Australia's ageing population continues to grow exponentially, their demand for hospital care also increases. Many nurses in the acute care setting have had little, if any, specialist education in the care of older people and therefore do not understand the extent of their needs. Coupled with the lack of specialist knowledge is the low status of older person care in this setting. Many nurses prefer to care for younger patients with acute illnesses that are curable (Nay 1993 in Nay & Garratt 2004: 61). As with the population at large, health care professionals hold negative views about old age and this is reflected in their attitudes. METHOD: The findings presented in this paper focus on data analysed from in depth interviews with nurses. As a prompt to discussions, nurses were presented with scenarios that exemplified both positive and negative attitudes to care. However, much of what was discussed in interviews focused on negative attitudes. Interviews with medical and allied health staff will be reported in a separate paper. RESULTS: The analysis of data with nurses reveals two themes and subthemes. 'Marginalisation and oppression of the older person' shows the ways in which nurses perceive older people are relegated to a lower status in the acute care setting, how this is 'contagious' and how 'lack of time' for care for older people is problematic and has become their 'catchcry'.'Stereotyping the older person' depicts some of the ways in which this evolves, for example, through 'Chinese Whispers' (UsingEnglish.com 2006), but has become part of the ageist culture.     

Nurses' attitudes towards sexual relationships between patients in high security psychiatric hospitals in England: an exploratory qualitative study

Background

The issue of relationships between patients in long-term care settings can present nurses with numerous challenges. However, addressing this element of patient care is recognised as an important element of nursing in this sphere of practice. What nurses think about patient sexual relationships and the difficulties of incorporating these into care is closely linked to the care they provide. However, the issue of patients sexual relationships within high security psychiatric hospitals is a relatively poorly researched area of clinical practice.

Aim

To explore the attitudes towards patients’ sexual relationships held by nurses working in high security psychiatric hospitals in England.

Methods and participants

A qualitative methodology was employed with data collected from 10 in-depth interviews with nurses working within secure psychiatric hospitals in England. Interview data were subjected to thematic analysis.

Results

Practitioners reject permissive policy in relation to patients’ sexual relationships on account of perceived perpetuation of abuse and exploitation. Practices and attitudes are dominated by personal (lay) values that seek to restrict patient experience and undermine professional mores whilst also seeming to uphold a professional duty of care.

Conclusion

Lay understandings are constructed as moral rights and priorities that are of higher order concern than professional values or the rights of the individual. This constitutes a clash of values and the minimisation of professional mores within the clinical context raises questions about the role of professional teaching, knowledge and policy in relation to professional socialisation.