CONSUMPTION OF PSYCHOACTIVE SUBSTANCES BY NURSING WORKERS: AN INTEGRATIVE REVIEW

Ribeiro, Ítalo Arão Pereira; Fernandes, Márcia Astrês; Rocha, Daniel de Macêdo; Silva, Joyce Soares e; Ribeiro, Hellany Karolliny Pinho; Soares, Nayana Santos Arêa

doi:10.1590/1980-265X-TCE-2018-0488

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Literature Review • Texto contexto - enferm. 29 • 2020 • https://doi.org/10.1590/1980-265X-TCE-2018-0488 copy

CONSUMPTION OF PSYCHOACTIVE SUBSTANCES BY NURSING WORKERS: AN INTEGRATIVE REVIEW

CONSUMO DE SUSTANCIAS PSICOACTIVAS POR PARTE DE TRABAJADORES DE ENFERMERÍA: UNA REVISIÓN INTEGRADORA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the scientific evidence available on the factors and implications related to the use of psychoactive substances by nursing workers.

Method:

an integrative review, which had the following as selection criteria: primary studies, published between 2008 and 2017, without language restrictions and that included aspects related to the consumption of psychoactive substances by nursing professionals. The bibliographic survey was carried out in the months of September and October 2018, in the following databases: CINAHL, MEDLINE, SCOPUS, Web of Science and LILACS, BDENF and IBECS via the Virtual Health Library.

Results:

a total of 14 articles were analyzed, with predominance of cross-sectional (28.57%), qualitative descriptive (28.57%), and quantitative descriptive (14.28%) studies, with significant samples ranging from 12 to 33,588 nursing professionals, and with 2C level of evidence (100.00%). The synthesis of knowledge was formulated in two categories: Predisposing factors for the consumption of psychoactive substances by nursing workers; and Implications of the use of psychoactive substances in personal life and in the quality of nursing care.

Conclusion:

the evidence found shows that the use of psychoactive substances represented a reality present in the daily lives of nursing workers and the close relationship with the working conditions represented the main associated factor, with the work environment being the major influencer for consumption.

DESCRIPTORS
Nursing; Nursing team; Psychotropic drugs; Worker's health; Substance-related disorders

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR:
Márcia Astrês Fernandes. m.astres@ufpi.edu.br

MeSH and CINAHL List
P	Controlled	Nurses; Nursing; Nursing, Team; Nurse Practitioners; Nurses' Aides; Nurses, Male;
	Non-controlled	Nurse; Personnel, Nursing; Nursing Personnel; Nursings; Team Nursing; Nurse Practitioner; Practitioner, Nurse; Practitioners, Nurse; Aide, Nurses'; Aides, Nurses'; Nurse Aides; Nurse's Aides; Nurses Aides; Nurses' Aide; Nursing Auxiliaries; Auxiliaries, Nursing; Auxiliary, Nursing; Nursing Auxiliary; Male Nurse; Male Nurses; Nurse, Male.
I	Controlled	Substance-Related Disorders; Street Drugs; Alcoholism; Tobacco; Psychotropic Drugs.
	Non-controlled	Drug Abuse; Abuse, Drug; Drug Dependence; Dependence, Drug; Drug Addiction; Addiction, Drug; Disorder, Substance Use; Substance use disorders; Disorder, Drug Use; Substance Abuse; Abuse, Substance; Abuses, Substance; Substance Abuses; Substance Dependence; Dependence, Substance; Substance Addiction; Addiction, Substance; Prescription Drug Abuse; Abuse, Prescription Drug; Drug Abuse, Prescription; Drug Habituation; Habituation, Drug; Drugs, Street; Illicit Drugs; Drugs, Illicit; Drugs of Abuse; Abuse Drugs; Recreational Drugs; Drugs, Recreational; Alcohol Dependence; Dependence, Alcohol; Alcohol Addiction; Addiction, Alcohol; Alcoholic Intoxication, Chronic; Chronic Alcoholic Intoxication; Intoxication, Chronic Alcoholic; Alcohol Use Disorder; Alcohol Use Disorders; Use Disorder, Alcohol; Use Disorders, Alcohol; Alcohol Abuse; Abuse, Alcohol; Tobaccos; Nicotiana; Nicotianas; Nicotiana tabacum; Nicotiana tabacums; tabacum, Nicotiana; Drugs, Psychotropic; Psychopharmaceuticals; Psychoactive Agents; Agents, Psychoactive; Psychoactive Drugs; Drugs, Psychoactive.
Co	Controlled	Occupational Health.
	Non-controlled	Health, Occupational; Safety, Occupational; Occupational Safety; Employee Health; Health, Employee; Working Conditions.
DeCS
P	Controlled	Enfermeiros e Enfermeiras; Enfermagem; Equipe de Enfermagem; Profissionais de Enfermagem; Auxiliares de Enfermagem; Enfermeiros.
	Non-controlled	Enfermeira; Enfermeira e Enfermeiro; Enfermeiras; Enfermeiro e Enfermeira; Enfermeiros e Enfermeiras; Enfermeiros de cabeceira; Enfermeiras de cabeceira; Enfermeiro.
I	Controlled	Transtornos Relacionados ao Uso de Substâncias; Drogas Ilícitas; Alcoolismo; Tabaco; Psicotrópicos.
	Non-controlled	Abuso de Drogas; Abuso de Substâncias; Abuso de Substâncias que Produzem Dependência; Abuso de Substâncias Psicoativas; Adição a Drogas; Adição às Drogas; Adição a Substâncias; Dependência de Substâncias; Dependência de Substâncias Psicoativas; Dependência Psíquica; Dependência Psíquica de Substâncias; Dependência Química; Drogadição; Drogadicção; Dependência de Drogas; Farmacodependência; Habituação a Drogas; Toxicodependência; Toxicomania; Uso Indevido de Drogas; Uso Indevido de Substâncias; Medicamentos Proibidos; Drogas de Abuso; Drogas de Uso Indevido; Drogas Recreativas; Abuso de Álcool; Intoxicação Alcoólica Crônica; Intoxicação por Álcool Crônica; Erva Nicotiana; Fumo; Nicociana; Nicotiana; Nicuciana; Agentes Psicoativos; Psicoativos; Psicofarmacos.
Co	Controlled	Saúde do Trabalhador; Condições de trabalho.
	Non-controlled	Saúde dos Empregados; Saúde Ocupacional; Higiene do Trabalho; Saúde dos Trabalhadores.

Predisposing factors for the use of psychoactive substances by nursing workers
Author/Year/Journal	Design/Sample/Level of Evidence	Classification and psychoactive substance	Main results, outcomes, and conclusions.
Junqueira MAB et al. 20171515. Junqueira MAB, Ferreira MCM, Soares GT, Brito IE, Pires PLS, Santos MA et al. Alcohol use and health behavior among nursing professionals. Rev Esc Enferm USP [Internet]. 2017 [cited 2018 Oct 24];51:e03265 Available from: http://doi.org/10.1590/s1980-220x2016046103265 . http://doi.org/10.1590/s1980-220x2016046... SCOPUS	Cross-sectional 416 - Nursing team 2C	Depressant (alcohol)	Sociodemographic and educational factors: male, single, higher education and nursing technician. Health behaviors: not practicing physical exercises or sports and drinking above the limit of two doses.
Dias JRF et al. 20111616. Dias JRF, Araújo CS, Martins ERC, Clos AC, Francisco MTR, Sampaio CEP. Factors favoring the use of psychotropics by nursing professionals. Rev Enferm UERJ [Internet]. 2011 [cited 2018 Oct 24];19(3):445-51. Available from: http://www.facenf.uerj.br/v19n3/v19n3a18.pdf http://www.facenf.uerj.br/v19n3/v19n3a18... SCOPUS	Qualitative and descriptive 15 - Nursing team 2C	Depressants (psychotropic drugs)	Physical and psychological wear, poor working conditions and inadequate work environment, stress, workload, demands and dissatisfaction in the work environment, team or family and easy access.
Catalina LH et al. 20121717. Catalina LH, Milena VCG, Alejandra SM. Consumo de sustancias psicoactivas en profesionales de la salud (médicos y enfermeros) de dos IPS de primer nivel de atención en consulta externa de Bogotá. Rev Cienc Salud [Internet]. 2012 [cited 2018 Dec 02]; 0(Suppl 1):87-100. Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S169272732012000400008&lng=en http://www.scielo.org.co/scielo.php?scri... SCOPUS	Cross-sectional 58 - Nurses 2C	Depressants (alcohol, antidepressants, opiates and barbiturates) Stimulants (tobacco, energy drinks and amphetamines)	Working conditions: High workload, need to be awake and relaxed, stress, easy access, and low pay.
Vieira TG et al. 20131818. Vieira TG, Beck CLC, Dissen CM, Camponogara S, Gobatto M, Coelho APF. Illness and the use of psychoactive drugs among nursing workers atintensive care units. Rev Enferm UFSM [Internet]. 2013 [cited 2018 Oct 24];3(2):205-14. Available from: http://doi.org/10.5902/217976927538 . http://doi.org/10.5902/217976927538... BDENF	Descriptive Quantitative 49 - Nursing team 2C	Depressants (antidepressants, benzodiazepines and analgesics)	Diagnosis of mental disorder, long experience in critical care units, night work, inadequate working conditions, easy access to psychotropic drugs, stress, tiredness, loss of family members, problems involving children's school performance. Also, feelings of sadness, anxiety and depression.
Rocha PR et al. 20151919. Rocha PR, David HMSL. Patterns of alcohol and drug consumption in health care professionals: a portrait of students of lato sensu courses in a public institution. SMAD, Rev. Eletr Saúde Mental Álcool Drog [Internet]. 2015 [cited 2018 Oct 24];11(1):42-8. Available from: http://doi.org/10.11606/issn.1806-6976.v11i1p41-48 . http://doi.org/10.11606/issn.1806-6976.v... LILACS	Cross-sectional 120 - Nurses 2C	Depressants (alcohol, anxiolytics, benzodiazepines and sedatives) Stimulants (tobacco and amphetamines)	Relaxation, celebration of special occasions, anxiety, sadness. Tiredness and long working hours.
Ficarra MG et al. 20112020. Ficarra MG, Gualano MR, Capizzi S, Siliquini R, Liguori G, Manzoli L, et al. Tobacco use prevalence, knowledge and attitudes among Italian hospital healthcare professionals. Eur J Public Health.[Internet]. 2011 [cited 2018 Oct 24];21(1):29-34. Available from: https://doi.org/10.1093/eurpub/ckq017 . https://doi.org/10.1093/eurpub/ckq017... MEDLINE	Sectional 258 - Nurses 2C	Stimulant (tobacco)	Professional category, in which nurses and assistants were more likely to consume the substance.
Schloze AR et al. 20172121. Scholze AR, Martins JT, Galdino MJ, Ribeiro RP. Occupational environment and psychoactive substance consumption among nurses. Acta Paul Enferm [Internet]. 2017 [cited 2018 Dec 02]; 30(4):404-11. Available from: https://doi.org/10.1590/1982-0194201700060. https://doi.org/10.1590/1982-01942017000... CINAHL	Cross-sectional 185 - Nurses 2C	Depressants (alcohol and sedative) Stimulant (tobacco)	Unfavorable work environment, interpersonal physician-nurse relationship, organizational support and professional autonomy.
Martins ERC et al. 20092222. Martins ERC, Zeitoune RCG, Francisco MTR. Conceptions of drugs by nursing workers: visibility of risks. Rev Enferm UERJ [Internet]. 2009 [cited 2018 Oct 06];17(3):368-72. Available from: http://www.facenf.uerj.br/v17n3/v17n3a12.pdf http://www.facenf.uerj.br/v17n3/v17n3a12... CINAHL	Descriptive - Qualitative 40 - Nursing team 2C	Depressant (alcohol) Stimulant (tobacco)	Relief from work and family problems.
Oliveira AF et al.20162323. Oliveira AF, Teixeira ER. Conception about self-medication use by the nursing staff in oncology intensive care. Rev Enferm UFPE Online [Internet]. 2015 [cited 2018 Oct 06];10(1):24-31. Available from: https://doi.org/10.5205/1981-8963-v10i1a10917p24-31-2016 . https://doi.org/10.5205/1981-8963-v10i1a... CINAHL	Descriptive, exploratory, and qualitative 25 - Nursing team 2C	Depressants (psychotropic drugs)	Easy access to the medication, self-confidence of knowing the drugs and their effects.
Mcnelis AM et al. 20122424. McNelis AM, Deutsch SH, Day POH, Gavardinas T, Outlaw C, Palmer R et al. Indiana State Nurses Assistance Program: identifying gender differences in substance use disorders. Perspectives Psychiatric Care [Internet]. 2012 [cited 2018 Oct 06];48(1):41-6. Available from: https://doi.org/10.1111/j.1744-6163.2010.00300.x https://doi.org/10.1111/j.1744-6163.2010... CINAHL	Prospective 1,338 - Nurses 2C	Depressants (alcohol and opioids)	Among men, there was greater propensity to consume alcohol and among women, opioids.
Sang E et al. 20172525. Sang E, Liao YM, Miao NF, Chou KR, Chung MH. Patterns and correlates of benzodiazepine use in nurses: A nationwide, population-based study. Int J Ment Health Nurs [Internet]. 2017 [cited 2018 Dec 02];27(1):400-7. Available from: https://doi.org/10.1111/inm.12334 https://doi.org/10.1111/inm.12334... CINAHL	Retrospective 33,588 - Nurses 2C	Depressant (benzodiazepines)	Sleep disorder, depression and anxiety, increased risk of benzodiazepine consumption.
Implications of the use of psychoactive substances in personal life and in the quality of nursing care
Bozimowski G et al. 20142626. Bozimowski G, Groh C, Rouen P, Dosch M. The prevalence and patterns of substance abuse among nurse anesthesia students. AANA J [Internet]. 2014[cited 2018 Dec 02];82(4):277-83. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25167607 https://www.ncbi.nlm.nih.gov/pubmed/2516... CINAHL	Prospective 111 - Nurses 2C	Depressants (opioids, alcohol, benzodiazepines) Hallucinogenic (cannabis) Stimulant (cocaine)	Dismissal from the graduate program, loss of nursing license and death. Factors: stress.
Oliveira EB et al. 20142727. Oliveira EB, Araujo PMB, Maia MPQ, Cabral JL, Brito DM, Figueredo EP. Occupational stress and consumption of anti-anxiety agents by nursing workers. Rev Enferm UERJ [Internet]. 2014 [cited 2018 Oct 06];22(5):615-21. Available from: https://www.epublicacoes.uerj.br/index.php/enfermagemuerj/article/view/15510/12242 https://www.epublicacoes.uerj.br/index.p... CINAHL	Descriptive, quantitative 91 - Nursing team 2C	Depressant (anxiolytics)	Work problems: stress, workload. Repercussion at work: early departures, overload to other professionals, work accidents, absences from work; medical care during the workday - sleepiness 24 (68.5%), and decreased reflexes 8 (22.8%). Such effects have repercussions for performance and organization.
Baggio MA et al. 20092828. Baggio MA, Formaggio FM. Self-medication: showing self carelessness by nursing professionals. Rev Enferm UERJ [Internet]. 2009[cited 2018 Oct 06];17(2):224-8. Available from: http://pesquisa.bvsalud.org/portal/resource/pt/bde-16399 http://pesquisa.bvsalud.org/portal/resou... BDENF	Exploratory, descriptive, qualitative 12 - Nursing team 2C	Depressants (analgesics and psychotropic drugs)	Access facilitated by environmental conditions, interpersonal relationships with other health or marketing professionals, knowledge of the effects of psychotropic drugs, monotony of everyday life, anxiety, depression, pain and pleasure. Dependence, neglect in self-care, risks of poisoning, allergic reactions and drug interactions.