This study prospectively evaluated the impact of a complete smoking bar on a locked psychiatric unit.
The setting was a 16-bed inpatient unit with 83% (134/162) involuntary patients, no off-unit smoking area, no possibility of granting smoking passes, and a mean length of stay of 2 weeks.
The effect of a complete smoking bar was measured by surveys of both staff and patients before and after the ban.
In addition, objective indicators of ward disruption were measured, including rates of aggression, use of p.r.n. medications, need for seclusion and restraints, elopement, and discharges against medical advice.
Although staff initially expressed concern about the ban's potential negative impact, after it began, t tests revealed that staff were significantly (p<. 05) less concerned about patients'needing more medication, becoming restless, being too fragile to cope with withdrawal, leaving the unit against medical advice, or trying to elope.
Staff were significantly (p<. 02) more positive about the bar than were patients.
Although patients, overall, had negative views toward the new policy, their opinions were somewhat less negative after its implementation.
Rates of assaultive behavior, use of seclusion and restraints, use of p.r.n. medication, and against-medical-advice or elopement discharges did not change after the bar was in effect.
When polled, 78% (40/51) of the staff voted to keep the ban. (...)
Mots-clés Pascal : Politique sanitaire, Service santé, Psychiatrie, Internement, Hospitalisation imposée, Réglementation, Consommation, Tabac, Attitude, Personnel sanitaire, Organisation hospitalière, Homme, Interdiction
Mots-clés Pascal anglais : Health policy, Health service, Psychiatry, Mentally ill commitment, Forced hospitalization, Regulation, Consumption, Tobacco, Attitude, Health staff, Hospital organization, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0413769
Code Inist : 002B18H05B. Création : 10/04/1997.