Understanding Jordanian Psychiatric Nurses’ Smoking Behaviors: A Grounded Theory Study

Abstract

Purpose. Smoking is prevalent in psychiatric facilities among staff and patients. However, there have been few studies of how contextual factors in specific cultures influence rates of smoking and the health promotion role of psychiatric nurses. This paper reports the findings of a classical grounded theory study conducted to understand how contextual factors in the workplace influences the smoking behaviors of Jordanian psychiatric nurses (JPNs). Method. Semi-structured individual interviews were conducted with a sample of eight male JPNs smokers at a psychiatric facility in Amman, Jordan. Findings. Constant comparative analysis identified becoming a heavy smoker as a psychosocial process characterized by four sub-categories: normalization of smoking; living in ambiguity; experiencing workplace conflict; and, facing up to workplace stressors. Conclusion. Specific contextual workplace factors require targeted smoking cessation interventions if JPNs are to receive the help they need to reduce health risks associated with heavy smoking.

Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study

“…These findings are supported by other studies [ 6 , 9 ] which found that nurses do not meet the recommended levels of physical activity required for the benefit of health (30 minutes, 5 days a week). Other behavioural risk factors that have been identified among nurses include smoking and alcohol abuse [ 11 - 14 ].…”

The delivery of smoking cessation interventions by nurses who smoke: A meta‐ethnographic synthesis

“…While the United States, Australia and New Zealand have long implemented smoke-free environments, compliance has been lower in Central and Eastern Europe countries and Jordan (Khalaf et al, 2017;Petersen et al, 2019). Also, smoking among health professionals was still seen as a common behaviour in psychiatric health settings (Aldiabat & Clinton, 2013). Many studies described how nurses were less likely to support the implementation of smoke-free policies.…”

“…On the one hand, they were happy to see patients enjoying a cigarette which 'reduced the negative impacts of their illness', but on the other hand they were aware that this contravened the rules. They described 'widespread tolerance' of smoking and the distribution of cigarettes to patients as being 'institutionalized' (Aldiabat & Clinton, 2013;Lawn & Condon, 2006).…”

“…'part of identity or personality', 'shore up self-esteem', 'promote feelings of personal wellbeing and freedom', 'make time at work go more quickly' and 'enhance concentration and alertness' (Aldiabat & Clinton, 2013). Furthermore, smoking was seen as 'the most effective' stress-coping strategy.…”

“…Furthermore, smoking was seen as 'the most effective' stress-coping strategy. Some nurses used cigarettes as a reward for themselves when completing tasks (Aldiabat & Clinton, 2013). One participant from the study by Sarna et al (2005) described smoking as a form of companionship commenting that 'It (cigarette) is my friend.…”