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JOURNAL READING
Exploring mental health professionals' practice in relation to
smoke-free policy within a mental health trust: a qualitative study
using the COM-B model of behaviour
OLEH :
Erlina Yulia
 Smoking has played a
significant role in the historical
culture of mental healthcare
settings.
 Mental health professionals
(MHPs) often hold dismissive
attitudes regarding the
importance of smoking
cessation in the context of
mental healthcare.
 In 2007, English mental health
inpatient buildings were
required by law to become
smoke-free, and healthcare
trusts have more recently
begun to implement
comprehensive and staff
training in response to
national guidance.
AIM
To explore these issues by
using the COM-B
(capability, opportunity,
motivation, behaviour)
model to systematically
identify barriers to, and
facilitators for, MHPs
addressing smoking with
their patients.
Period : March - August 2017
Total sampel : A total of 36 MHPs employed by NHS
England partici-pated in the study.
Type of Analysis : Thematic Analysis
Type of
Research
Qualitative
Purposive
sampling
Technique
RESEARCH METHODS
Interview Protocol
The interview protocol
was devised following
a systematic review of
the literature
The resulting topic
guide included the
following themes:
Experiences of
addressing
smoking with
mentalhealth
patients Attitudes toward
smoking cessation
and harmreduction
in the mental health
context
Attitudes and
adherence to the
smoke-free
policyand mandatory
training
Results :
Addressing
smoking with
patients was
undermined
by MHPs
psychological
capability to recall
training content,
misunderstand the
potential benefits of
addressing patient
smoking and harm
reduction approaches physical
opportunity in
terms of time
constraints, and
easy accessibility
of tobacco in the
community
Social opportunity in
terms of increased
cultural value of
tobacco following
inpatient smoke-free
policy
implementation, and
lack of support from
colleagues to enforce
the smoke-free policy
automatic
motivation,
including intrinsic
biases regarding
patients abilities
and motivations to
quit
reflective
motivation,
including perceived
job role
anddecision making
processes related to
addressing
behaviours deemed
more important
than smoking
 This study highlighted :
 The lack of physical opportunity which community MHPs
feel they have to discuss smoking with their patients
 Often referring to time constraints and the inability to
monitor patients’ progress because of having limited face-to-
face contact with patients. In line with the behaviour change
wheel, enabling MHPs by increasing access to resources
which can be used in the community may assist in
overcoming this barrier, which could improve the motivation
of both the patient and MHPs
Discussions :
Multiple barriers were identified across all key
domains of the COM-B framework that undermine
MHPs’practice regarding smoking cessation. Few
facilitators were identified which may have
implications for future smoke-free policy and
clinical practice.
THANK YOU

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smoke-free policy within a mental health trust

  • 1. JOURNAL READING Exploring mental health professionals' practice in relation to smoke-free policy within a mental health trust: a qualitative study using the COM-B model of behaviour OLEH : Erlina Yulia
  • 2.  Smoking has played a significant role in the historical culture of mental healthcare settings.  Mental health professionals (MHPs) often hold dismissive attitudes regarding the importance of smoking cessation in the context of mental healthcare.  In 2007, English mental health inpatient buildings were required by law to become smoke-free, and healthcare trusts have more recently begun to implement comprehensive and staff training in response to national guidance.
  • 3. AIM To explore these issues by using the COM-B (capability, opportunity, motivation, behaviour) model to systematically identify barriers to, and facilitators for, MHPs addressing smoking with their patients.
  • 4. Period : March - August 2017 Total sampel : A total of 36 MHPs employed by NHS England partici-pated in the study. Type of Analysis : Thematic Analysis Type of Research Qualitative Purposive sampling Technique RESEARCH METHODS
  • 5. Interview Protocol The interview protocol was devised following a systematic review of the literature The resulting topic guide included the following themes: Experiences of addressing smoking with mentalhealth patients Attitudes toward smoking cessation and harmreduction in the mental health context Attitudes and adherence to the smoke-free policyand mandatory training
  • 6. Results : Addressing smoking with patients was undermined by MHPs psychological capability to recall training content, misunderstand the potential benefits of addressing patient smoking and harm reduction approaches physical opportunity in terms of time constraints, and easy accessibility of tobacco in the community Social opportunity in terms of increased cultural value of tobacco following inpatient smoke-free policy implementation, and lack of support from colleagues to enforce the smoke-free policy automatic motivation, including intrinsic biases regarding patients abilities and motivations to quit reflective motivation, including perceived job role anddecision making processes related to addressing behaviours deemed more important than smoking
  • 7.  This study highlighted :  The lack of physical opportunity which community MHPs feel they have to discuss smoking with their patients  Often referring to time constraints and the inability to monitor patients’ progress because of having limited face-to- face contact with patients. In line with the behaviour change wheel, enabling MHPs by increasing access to resources which can be used in the community may assist in overcoming this barrier, which could improve the motivation of both the patient and MHPs Discussions :
  • 8. Multiple barriers were identified across all key domains of the COM-B framework that undermine MHPs’practice regarding smoking cessation. Few facilitators were identified which may have implications for future smoke-free policy and clinical practice.