Mental health nurses’ knowledge, attitude and practices related to tobacco dependence among mental health care users at a psychiatric institution in the Western Cape
Research reported that it is very challenging for mental health care users to quit smoking and the risk of relapsing after quitting is high. However, tobacco dependence treatment is possible and potentially lifesaving for people. The delivery of tobacco dependence treatment by nurses is influenced by a variety of factors, including lack of knowledge and skills, limited professional leadership, and smoking within the profession. There is a strong link between mental illness and smoking-related diseases, including cancer, respiratory diseases and heart diseases that are linked with depression. There is a high incidence of cancer in people with bipolar mood disorder and schizophrenia due to smoking. In spite of this, smoking is regarded as part of the culture of psychiatric institutions and tobacco is seen as “necessary self- medication for the mentally ill”. Historically, cigarettes have been used for behavioural reinforcement within the psychiatric setting. Mental health nurses also have the highest rate of smoking behaviour, which is coupled with permissive attitudes towards smoking among Mental health care users. It is also reported that nurses lack knowledge regarding the interaction of tobacco dependence with treatment of mental disorders. Nurses are also regarded as role models and therefore, nurses’ beliefs and attitudes regarding the smoking behaviour of mental health care users have an influence on any smoking cessation interventions. The psychiatric institution where the researcher was employed had recently implemented a smoke-free policy in the wards. The aim of this study was to investigate the knowledge, attitude and practices of mental health nurses related to tobacco dependence among MHCUs in a psychiatric institution in the Western Cape. The researcher used a descriptive survey design to carry out this study at a selected government-funded tertiary psychiatric hospital in theWestern Cape, South Africa. The target population comprised all mental health nurses permanently employed at this institution (169) and all-inclusive sampling was used. Data was analysed using SPSS Statistics version 24. The findings of the study reveal mental health nurses had good knowledge on tobacco dependence among MHCUs and that they had positive attitudes regarding the need to combat tobacco dependence among MHCUs. This is revealed through their knowledge on the dangers of smoking to MHCUs. The quality of training influences knowledge, which in turn cultivates a positive attitude regarding the need to combat tobacco and smoking addiction among MHCUs. There is also difference between the attitudes of non-smokers and those of smokers regarding the treatment of nicotine and tobacco dependence in MHCUs. For instance, mental health nurses who smoke perceive smoking as a necessary element for creating relationships with their patients, and therefore they tend to have a relaxed attitude towards treating smoking addiction among patients. Those who do not smoke tend to perceive combating nicotine dependence as essential. A recommendation is that some form of training for mental health nurses is needed to cultivate positive attitudes towards strategies meant to curb smoking addiction.