Problematic substance use in midwives registered with the United Kingdom’s Nursing and Midwifery Council: A pragmatic mixed methods study

Pezaro, Sally and Maher, Karen and Bailey, Elizabeth and Pearce, Gemma (2022) Problematic substance use in midwives registered with the United Kingdom’s Nursing and Midwifery Council: A pragmatic mixed methods study. Midwifery, 112. p. 103409. ISSN 0266-6138

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Abstract

Objective
Use a pragmatic mixed methods approach to provide a rich understanding of the perceptions of Problematic Substance Use (PSU) and the influences of PSU on the mental and physical health of midwives registered with the Nursing and Midwifery Council (NMC).

Design
A confidential and anonymous self-administered online survey was employed to encourage wider participation.

Setting
United Kingdom

Participants
Midwives (n=623) registered with the NMC

Measurements
Open text responses were invited throughout the survey. Along with the collection of brief demographic data, PSU was also measured using the Tobacco, Alcohol, Prescription Medications, and Substance Use/Misuse (TAPS) Tool whilst mental and physical health was measured via version 2 of the Medical Outcomes Study Short-Form 12-Item Health Survey. All qualitative open text responses were analysed inductively using reflexive thematic analysis. Multiple regression was used to test whether health outcomes in the sample as a whole were predicted by PSU and Mann-Whitney U tests to compare the health dimensions between participants who met the criteria for PSU and those who did not.

Findings
PSU significantly predicted poorer general health, physical functioning, and mental functioning. Additionally, those who met criteria for PSU experienced significantly poorer general, mental, and physical health than those who did not. The influence of PSU was captured via 3 themes and 10 subthemes. Though the signs and symptoms of PSU identified remained broadly consistent, approaches to management did not. Many midwives were conflicted in how they might seek support without facing professional, personal and practical reprisal.

Key conclusions and implications for practice
PSU in midwifery populations poses professional, personal, and occupational risks. Congruence between policies and approaches to identification and management may reduce risk overall. Future interventions including educational and practitioner health programmes could also be usefully co-created with midwives, policy, and decision makers to reduce stigmatising attitudes and encourage greater awareness, compassion and help seeking to appropriate sources.

Item Type:	Article
Identification Number:	10.1016/j.midw.2022.103409
Dates:	Date Event 19 June 2022 Accepted 20 June 2022 Published Online
Uncontrolled Keywords:	Midwives, Midwifery, Substance use, Addiction, Impairment, Occupational health
Subjects:	CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-04 - midwifery
Divisions:	Faculty of Health, Education and Life Sciences > College of Health and Care Professions
Depositing User:	Elizabeth Bailey
Date Deposited:	10 Aug 2022 12:01
Last Modified:	10 Aug 2022 12:01
URI:	https://www.open-access.bcu.ac.uk/id/eprint/13469

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