Occupational environment and psychoactive substance consumption among nurses

Cross-sectional and descriptive study, involving nurses from three public hospitals in a city in the South of Brazil, being two medium-complexity and one high-complexity institution. The study population consisted of 221 nurses. Based on this figure, the stratified sample size was calculated, considering a 50% proportion, 95% confidence level and 5% maximum error, resulting in a minimum number of 175 participants. Through proportional stratification per institution, a minimum of 103 high-complexity nurses was defined, as well as 36 nurses from each medium-complexity institution. The following inclusion criteria were adopted: having worked at the institution for at least one year and not being on leave. The data were collected between October 2015 and April 2016. In the data collection, sociodemographic and occupational information, the Nursing Work Index - Revised and the Alcohol, Smoking and Substance Involvement Screening Test. The data were analyzed in the software Statistical Package for Social Sciences, version 20.0. Initially, the normality was verified by means of the Kolmogorov-Smirnov test. Descriptive analyses were developed by absolute and relative frequencies for the categorical variables; and medians and dispersion measures for the numerical variables.

Results

Alcohol, tobacco and sedatives were the most consumed substances. The monthly income was positively correlated with alcohol consumption among nurses at the medium-complexity hospitals (p=0.01). At the high-complexity hospital, alcohol consumption was negatively correlated with the physician-nurse index (p=0.03). Autonomy, physician-nurse index and organizational support were negatively correlated with the use of sedatives (p<0.01; p<0.01; p=0.02, respectively).

Conclusion

The more negative the nurse’s work environment, mainly in the relation with physicians, organizational support and autonomy, the greater the consumption of psychoactive substances.

Keywords
Working environment; Alcoholic beverages; Street drugs; Substancerelated disorders; Nurses

Subscales	Medium complexity		High complexity
Subscales	Median (IIQ)^* * Interquartile interval (P25-P75)	Minimum/Maximum	Median (IIQ)^* * Interquartile interval (P25-P75)	Minimum/Maximum
Autonomy	11.0(8.0-12.0)	5.0-17.0	9.0(8.0-11.0)	5.0-19.0
Control over the environment	19.0(16.0-23.0)	7.0-27.0	16.0(13.0-19.0)	7.0-27.0
Physician-nurse index	7.0(6.0-8.0)	4.0-11.0	6.0(5.0-7.0)	3.0-12.0
Organizational support	26.0(21.0-29.0)	12.0-35.0	22.0(18.0-25.0)	10.0-37.0

Variables^* * Some participants indicated the use of two or more substances. No consumption of hallucinogenic drugs was indicated		Use in the lifetime	Use in the past three months	Desire or urge to consume	Associated problems	Activity neglect	Concern by others	Attempts to reduce
		n(%)	n(%)	n(%)	n(%)	n(%)	n(%)	n(%)
Medium complexity
	Tobacco	36(44.4)	11(13.6)	11(13.6)	3(3.7)	-	5(6.2)	12(14.8)
	Alcohol	63(77.8)	48(59.3)	24(29.6)	2(2.5)	1(1.2)	4(5.0)	7(8.6)
	Sedatives	15(18.5)	3(3.7)	2(2.5)	-	-	1(1.2)	3(3.7)
	Marihuana	12(14.8)	1(1.2)	-	-	-	-	1(1.2)
	Opioids	5(6.2)	2(2.5)	-	-	-	-	-(-)
	Amphetamines	5(6.2)	3(3.7)	-	-	-	-	2(2.5)
	Inhalants	6(7.4)	1(1.2)	-	-	-	-	1(1.2)
	Cocaine	3(3.7)	1(1.2)	-	-	-	-	3(3.7)
	Others	4(4.9)	1(1.2)	1(1.2)	-(-)	-(-)	-(-)	1(1.2)
High complexity
	Tobacco	33(31.7)	12(11.5)	11(10.6)	2(1.9)	1(1.0)	5(4.8)	8(7.7)
	Alcohol	73(70.2)	65(62.5)	31(29.8)	2(1.9)	2(1.9)	5(4.8)	3(2.9)
	Sedatives	13(12.5)	4(3.8)	3(2.9)	2(1.9)	2(1.9)	3(2.9)	1(1.0)
	Marihuana	6(5.8)	3(2.9)	-(-)	-(-)	-(-)	1(1.0)	-(-)
	Opioids	3(2.9)	1(1.0)	-(-)	-(-)	-(-)	-(-)	-(-)
	Amphetamines	2(1.9)	2(1.9)	-(-)	-(-)	-(-)	-(-)	-(-)
	Inhalants	1(1.0)	-(-)	-(-)	-(-)	-(-)	-(-)	1(1.0)
	Cocaine	1(1.0)	-(-)	-(-)	-(-)	-(-)	1(1.0)	-(-)
	Others	4(3.8)	-(-)	-(-)	-(-)	-(-)	-(-)	-(-)

Variables		Alcohol		Tobacco		Sedative
Variables		ro^* * Spearman’s correlation coefficient	p-value	ro^* * Spearman’s correlation coefficient	p-value	ro^* * Spearman’s correlation coefficient	p-value
Medium complexity
	Age	-0.13	0.31	-0.07	0.56	0.07	0.59
	Physical exercise	0.25	0.05	0.09	0.45	-0.15	0.24
	Monthly income	-0.31	0.01	0.05	0.68	0.01	0.89
	Autonomy	-0.23	0.07	0.04	0.71	0.08	0.50
	Control over the environment	-0.12	0.33	0.07	0.57	0.11	0.37
	Physician-nurse index	-0.09	0.46	0.11	0.39	0.18	0.15
	Organizational support	-0.17	0.89	0.12	0.33	0.08	0.52
High complexity
	Age	-0.09	0.48	0.29	0.02	-0.16	0.20
	Physical exercise	0.04	0.74	0.08	0.52	0.07	0.56
	Monthly income	0.05	0.66	0.19	0.14	0.07	0.56
	Autonomy	-0.13	0.29	-0.07	0.58	-0.39	0.00
	Control over the environment	-0.27	0.03	-0.14	0.28	-0.41	0.00
	Physician-nurse index	0.03	0.77	-0.02	0.86	-0.13	0.31
	Organizational support	-0.09	0.47	-0.09	0.47	-0.28	0.02

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author Alessandro Rolim Scholze Rodovia BR, 369, Km 54, s/n, 86360-000, Bandeirantes, PR, Brazil. scholze@uenp.edu.br