Integration of Theory-Based Tobacco Education

Introduction

As a healthcare professional, we are aware of the correlation between the usage of tobacco-based products and nicotine dependence. To this day smoking remain one of the most seriously and deadly public health issue, due to its ongoing effect on our vulnerable populations, especially those suffering from mental illnesses. In order to achieve relevant and efficient level of care for those healthcare clients which may suffer from nicotine based addictions, we must first explore the coexisting relationship between recognizing the specific needs of those individuals, and the ability of the healthcare team to adequately meet those needs. One of the barriers towards achieving efficient level of care especially in the psychiatric nursing care is the lack of educational curriculums focusing on the usage of tobacco-based products and the possibility of nicotine dependence. This result in decline level of knowledge predominantly in psychiatric nurses furthermore effecting the provision of successful intervention. At the same time the neurobiological and psychosocial links to smoking appear stronger in certain individuals who suffer from mental illnesses such as schizophrenia and general depression disorders. In addition, long term cigarette consumers suffering from nicotine dependence and are at increased, risk of developing smoking-related morbidities which can fatally impact their quality of life, especially in smokers with co-existing mental illness.

Article Summary

According to the article, title “Making a Case for Systematic Integration of Theory-Based Tobacco Education into Graduate Psychiatric/Mental Health Nursing Curriculum,” the authors, conducted specifically focused research using statistical data (Schwindt R.G., & Sharp D., 2013). This article research supports the specific statements that the use of tobacco-based products is significantly higher among specifically population group, such as the people suffering from mental illness (Schwindt R.G., & Sharp D., 2013). The neurobiological and psychosocial links to smoking appear stronger in certain individuals who suffer from mental illnesses such as schizophrenia and general depression disorders. This article specify that all participants of this group should exhibit the same or similar psychological issues; “presence of broad range of mental, emotional or behavioral conditions that cause significant functional impairment, thereby limiting the person's ability to engage fully in life activities,” (Schwindt R.G., & Sharp D., pp.166, 2013). According to the statistical data present in the article,” persons with SMI's represent only 22% of the population as a whole, those who smoke consume 187 billion cigarettes per year, which accounts for 44% of the tobacco market,” (Schwindt R.G., & Sharp D., pp.166, 2013). In addition, long term cigarette consumers suffering from nicotine dependence and are at increased, risk of developing smoking-related morbidities which can fatally impact their quality of life, especially in smokers with co-existing mental illness. The authors Schwindt R., and Sharp D., informed us that all of the fallowing medical conditions are effected to certain degree by smoking, and in some specific respiratory-based illnesses we see significant worsening of these conditions. Those conditions include on a first place “cardiovascular disease, fallow by chorionic pulmonary obstructive disease, cancer, diabetes, and stroke,” (Schwindt R.G., & Sharp D., pp.166, 2013). “As a result, they have a life expectancy that is 25 years shorter than the general population,” (Schwindt R.G., & Sharp D., pp.166, 2013). In addition, according to the article “tobacco dependence, even in the absence of depressive symptoms or substance abuse, can be predictive of future suicidal behavior,” (Schwindt R.G., & Sharp D., pp.166, 2013). Knowing this information can be very helpful to psychiatric nurses.

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Moving along according to Schwindt R., and Sharp D., a public health issue of this magnitude demands a multi-level approach that is first easy to grasp by the team members and the patents and second easy to coordinate between all the levels of the healthcare team. One of the barriers towards achieving efficient level of care especially in psychiatric nursing care is the lack of educational curriculums focusing on the usage of tobacco based products and the possibility of nicotine dependence. This result in decline level of knowledge predominantly in psychiatric nurses furthermore effecting the provision of successful intervention. In addition, research findings indicate that psychiatric nurses may hesitate to include smoking prevention goal in the plan of acre if physiological manifestation are not present (Schwindt R.G., & Sharp D., pp.167, 2013). According to Schwindt R., and Sharp D., most of the educational curriculums that are part of the requirements for obtaining a degree in bachelor of science in nursing in the United States, required “less than 2 hours of actual teaching time for tobacco use and dependence, with many allocating less than 1 hour,” (Schwindt R.G., & Sharp D., pp.167, 2013). In addition, the article also disclosed that although, “the majority of both BSN and graduate programs include some content related to the health effects of smoking (96.5% and 90.0%, respectively), few offer material on clinical cessation techniques, or require any clinical experience related to tobacco dependence treatment,” (Schwindt R.G., & Sharp D., pp.167, 2013). Although, some mental health facility offer post-graduating training opportunity to newly grad psychiatric nurses. Mental health professionals report that those training opportunities are either to limited or, when available to time-consuming (Schwindt R.G., & Sharp D., 2013). Furthermore, escalating the problem of excessive tobacco dependency among the mentally ill client population (Schwindt R.G., & Sharp D., 2013).

Finally, one of the possible solution that the authors discus in this article is Self-determination theory. Self-determination theory discus the importance of human motivation as the leading force of behavior changes, by combining first-hand rationally based information with evidence based practices addressing the current issue (Schwindt R.G., & Sharp D., pp. 168, 2013). According to the article so called autonomously, motivation which is imbedded in the self-determination theory helps people initiates behavior changes by allowing a person to play with their freedom and to act independently (Schwindt R.G., & Sharp D., 2013). In addition, to prove that self-determination theory work effectively when used the authors, conducted a specifically designed research study for mental health professionals who attended a smoking cessation workshop led by SDT trainers (Schwindt R.G., & Sharp D., 2013). The results show that mental health professionals especially psychiatric nurses “were more likely to integrate tobacco-dependence counseling into their practices if they felt more autonomously motivated,” (Schwindt R.G., & Sharp D., pp.168, 2013). In sum, participation in tobacco dependence training promotes an increase in knowledge and confidence, the adoption of more positive attitudes, and more frequent use of, or intentions to integrate, tobacco cessation interventions into clinical practice.

Article Critique

This article has the strengths of providing various sources to back up the data It is explained in an easy to follow manner with tables for further visualization. Some weaknesses include lacking some explanation of what some of the numbers mean in correlation to the study, also, this was a convenience sample and not a random sample of participants. This study also took a very specific group of people and was a very small scale, so results nationwide may be different.

I would recommend this article to a colleague. I think it is helpful for nurse and health-care professionals to think about when caring for this specific type of group and use it to further improved and individualization of care for these clients.

Conclusion

As a healthcare professionals, we are aware of the correlation between the usage of tobacco based products and nicotine dependence. To this day smoking remain one of the most seriously and deadly public health issue, due to its ongoing effect on our vulnerable populations, especially those suffering from mental illnesses. In order to achieve relevant and efficient level of care for those healthcare clients which may suffer from nicotine based addictions, we must first explore the coexisting relationship between recognizing the specific needs of those individuals, and the ability of the healthcare team to adequately meet those needs. One of the barriers towards achieving efficient level of care especially in the psychiatric nursing care is the lack of educational curriculums focusing on the usage of tobacco-based products and the possibility of nicotine dependence. “Participation in tobacco dependence training promotes an increase in knowledge and confidence, the adoption of more positive attitudes, and more frequent use of, or intentions to integrate, tobacco cessation interventions into clinical practice,” (Schwindt R.G., & Sharp D., pp.169, 2013). “Self-determination theory is a useful framework for the development of such a program by providing the means to understand the motivation required to adopt a new behavior, such as tobacco cessation counseling,” (Schwindt R.G., & Sharp D., pp.169, 2013).

References

1. Schwindt R.G., Sharp D., (2013) Making a Case for Systematic Integration of Theory-Based Tobacco Education into Graduate Psychiatric/Mental Health Nursing Curriculum
2. Archives of Psychiatric Nursing, 27 (4), pp. 166-170