Among people with psychiatric disorders, smoking is the leading cause of premature mortality. In this context, what is the role of the caregiver with the smoking patient? Support or prohibit? Not worrying about tobacco consumption, a lesser problem compared to psychiatric disorders? This dissertation questions individual and team practices in order to improve the care of smokers with psychiatric disorders. Summary by the author, Laurence Fabaron, liaison addiction nurse.
Smoking is the leading cause of premature death for people with psychiatric disorders. Their quality of life is strongly impacted by this consumption in terms of somatic, psychological, but also social and financial health. Nurse in the addiction liaison team (ELSA) at the Alpes Isère Hospital Center (CHAI), this thesis work consists of better understanding the representations of caregivers in a post-emergency psychiatric service on the subject of smoking by trying to answer this question: “What is the place of caregivers in the management of smoking in smoking patients with acute psychiatric disorders?” “.
Method : Qualitative study carried out on eight APEX healthcare staff members, volunteers. The study was carried out at two separate times within the framework of group interviews based on two questions: “ What tobacco-related problems do you face in your work? » et « In your opinion, what are the tobacco-related problems that patients hospitalized in your department face? »
Results: Four points emerge from this investigation: the material problem (no tobacco, no money, state of craving), relational issues (patient calm but also conflicts), ethics (patients’ rights in forced hospitalizations but also the emergence of smoking due to boredom) and the institutional question (no rules regulate smoking).
Discussions : Smoking in a psychiatric post-emergency department raises many questions and tends to divide the different members of a team. Support or prohibit? Not worrying about tobacco consumption, a lesser problem compared to psychiatric disorders? Between smoking and non-smoking caregivers, the discourse and practices are not the same. It would therefore be necessary to begin thinking about smoking in this context, to question individual and team practices and finally to consider proposals to improve mental health care for smokers.
• Laurence Fabaron, “Reflections on smoking in a psychiatric post-emergency department”, Alpes Isère Hospital Center, 2018-2019 (PDF).
