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Biomedical subjects

C L Storr

Publications and source records attributed to C L Storr.

18 recordsLinked to original sources
PubMed2001

Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses.

Pain and fatigue are early indicators of musculoskeletal strain. This study examined associations among eight physical demands and inadequate sleep, pain medication use, and absenteeism in 3727 working registered nurses (RNs). Among the demands, awkward head/arm postures were associated with each outcome (inadequate sleep: odds ratio [OR], 1.96; 95% confidence interval [CI], 1.41 to 2.72; pain medication: OR, 1.65; CI, 1.12 to 2.24; absenteeism: OR, 1.60; CI, 1.26 to 2.04). A dose-response relationship was present; as the number of demands increased, the likelihood of each outcome increased. Odds ratios for eight demands versus no demands were as follows: inadequate sleep (OR, 5.88; CI, 2.30 to 15.50), pain medication (OR, 3.30; CI, 1.34 to 8.11), and absenteeism (OR, 2.13; CI, 1.15 to 3.94). Adjustment using multiple logistic regression for lifestyle, demographics, and work schedule did little to alter the findings. Interventions to promote nurses' health should limit the physical demands of the work.

Absenteeism↗
PubMed2000

Similarities of substance use between medical and nursing specialties.

This paper reviews and compares alcohol and other drug involvement findings in two professions, medicine and nursing, by specialty. Health care providers are naturally subgrouped by specialty, as this is a major work environment factor. The evidence indicates an association exists between practicing in certain medical or nursing specialties and substance use. In addition, similarities in specialty membership and substance use across medicine and nursing suggests there may be common risk factors related to substance use that could be addressed using interdisciplinary approaches.

Female↗
PubMed1999

Job strain and non-medical drug use.

In this study, the Karasek demand/control formulation of job strain, initially used in research on cardiovascular health, has been extended to drug use. Full-time nurses (n = 2375), all participants in a national anonymous mailed survey, were an estimated 1.5 times more likely to be a recent non-medical drug user if they had a high strain job as compared to nurses in low strain jobs. The psychosocial work environment might influence whether nurses become and remain non-medical drug users, over and above the risk-modifying functions related to nurses' individual vulnerabilities and their greater access to controlled substances.

Adult↗
PubMed1999

Prescription-type drug misuse and workplace access among nurses.

Access to prescription-type substances in the workplace is a unique feature of the practice of health professionals. Empirical data on the relation between workplace access to substances and prescription-type drug misuse among nurses are limited. Using an anonymous mailed survey, data were collected on three dimensions of access: perceived availability, frequency of administration, and degree of workplace control over storage and dispensing of substances. Each dimension was independently associated with increased use. When these dimensions were combined into an index, nurses with very easy access were most likely to have misused prescription-type drugs (adjusted Odds Ratio = 4.18; 95% Confidence Interval: 1.70-10.30). Level of knowledge of controlled substances was also associated with use, but did not explain the relation between access and use.

Adult↗
PubMed1999

Physician substance use by medical specialty.

Self-reported past year use of alcohol, tobacco, marijuana, cocaine, and two controlled prescription substances (opiates, benzodiazepines); and self-reported lifetime substance abuse or dependence was estimated and compared for 12 specialties among 5,426 physicians participating in an anonymous mailed survey. Logistic regression models controlled for demographic and other characteristics that might explain observed specialty differences. Emergency medicine physicians used more illicit drugs. Psychiatrists used more benzodiazepines. Comparatively, pediatricians had overall low rates of use, as did surgeons, except for tobacco smoking. Anesthesiologists had higher use only for major opiates. Self-reported substance abuse and dependence were at highest levels among psychiatrists and emergency physicians, and lowest among surgeons. With evidence from studies such as this one, a specialty can organize prevention programs to address patterns of substance use specific to that specialty, the specialty characteristics of its members, and their unique practice environments that may contribute risk of substance abuse and dependence.

Adult↗
PubMed1998

Work schedule characteristics and substance use in nurses.

BACKGROUND: In order to promote the health of nurses while maintaining performance and patient care safety standards, better research bases on the association of work organization with health are needed. METHODS: Work schedule components (shift, shift length, weekends, and overtime) in a nationally representative sample of employed registered nurses participating in an anonymous mailed survey (n = 3,917) were examined in relation to past year alcohol, smoking and drug use. RESULTS: Schedule components examined separately showed modest associations with substance use. Combinations of shift and shift length interacted in association with substance use, so that nurses working night shifts > 8 hr had the highest likelihood of alcohol use and smoking and those working rotating shifts > 8 hr were more likely to report alcohol use. Among women, the likelihood of substance use under adverse conditions varied by family/home demands. CONCLUSIONS: Administrative attention to the interplay of work schedules on workers along with consideration of competing family/home demands could lead to more healthful scheduling. In addition to substance use, working longer night and rotating shifts might be related to other health behaviors and conditions that should be examined in the future.

Alcohol Drinking↗
PubMed1998

Substance use among nurses: differences between specialties.

OBJECTIVES: Valid data on factors that increase a health care worker's likelihood of substance use are integral in ensuring professional standards and quality health care for consumers. This study explored the association between nursing specialty and past-year substance use. METHODS: In an anonymous mailed survey, a balanced stratified sample of registered nurses (n = 4438) reported their use of marijuana, cocaine, and prescription-type drugs, as well as cigarette smoking and binge drinking. RESULTS: Prevalence of use of all substances was 32%. Rates varied by specialty, even when sociodemographics were controlled. Compared with nurses in women's health, pediatrics, and general practice, emergency nurses were 3.5 times as likely to use marijuana or cocaine (odds ratio [OR] = 3.5; 95% confidence interval [CI] = 1.5, 8.2); oncology and administration nurses were twice as likely to engage in binge drinking; and psychiatric nurses were most likely to smoke (OR = 2.4; 95% CI = 1.6, 3.8). No specialty differences appeared for prescription-type drug use. CONCLUSIONS: Certain nursing specialties were more likely than others to be associated with substance use. The differences were not explained by demographic characteristics. Inasmuch as a comparison of these results for nurses with prior work on physicians found considerable agreement by specialty, preventive initiatives should consider inter-disciplinary approaches to substance use education.

Adult↗
PubMed1997

Collecting substance use data with an anonymous mailed survey.

Because mailed surveys minimize personal contact, they are useful for collecting sensitive data on substance use, as long as the problems of achieving adequate response rates can be conquered. To address these issues, we report on an anonymous mailed survey of substance use with a 78% response rate, including data collection and survey methods. Analysis of sociodemographic effects on responding found certain groups required additional contacts. Substance use estimates were not affected by non-response bias, suggesting that anonymous mailed surveys can be a feasible means of collecting data on substance use.

Adult↗
PubMed1996

Substance use by surgical residents and students entering surgery.

We studied the use of alcohol, tobacco, and nine unprescribed or illegal substances by surgical residents and medical students accepted into surgical programs. With the exception of alcohol, surgical residents had less lifetime experience and used less than other residents or nonmedical college graduates. Students entering surgery had used these substances more frequently and were more likely to be using them regularly than were residents. Residency directors need to be aware of the change in attitude and use patterns of present residents as compared with those of the past.

Adult↗
PubMed1994

Relationship of specialty and access to substance use among registered nurses: an exploratory analysis.

Substance use patterns among nurses and women in general are understudied, especially how substance use relates to the work environment. Using an anonymous survey mailed to a population based random sample of registered nurses, this study presents the first empirical evidence that working in a critical care specialty combined with easy workplace access to drugs is associated with a high likelihood of illicit drug use among nurses (O.R. = 6.2).

Adult↗
PubMed1992

Prevalence of substance use among US physicians.

OBJECTIVE: To estimate the prevalence of substance use among US physicians. DESIGN: A mailed, anonymous, self-report survey that assessed use of 13 substances and permitted comparison with results of the National Household Survey on Drug Abuse. Rates of physician substance use were weighted to provide national prevalence estimates. PARTICIPANTS: A national sample of 9600 physicians, stratified by specialty and career stage, and randomly selected from the American Medical Association master file. The response rate after three mailings was 59%. Demographic characteristics of respondents closely reflected those of the US physician population. MAIN OUTCOME MEASURES: Subjects' self-reported use of 13 substances in their lifetime, the past year, and the past month; reasons for use; self-admitted substance abuse or dependence; and whether treatment was received. For controlled prescription substances, respondents were asked to report only use "not prescribed by another physician for a legitimate medical or psychiatric condition." RESULTS: Physicians were less likely to have used cigarettes and illicit substances, such as marijuana, cocaine, and heroin, in the past year than their age and gender counterparts in the National Household Survey on Drug Abuse. They were more likely to have used alcohol and two types of prescription medications--minor opiates and benzodiazepine tranquilizers. Prescription substances were used primarily for self-treatment, whereas illicit substances and alcohol were used primarily for recreation. Current daily use of illicit or controlled substances was rare. CONCLUSIONS: Although physicians were as likely to have experimented with illicit substances in their lifetime as their age and gender peers in society, they were far less likely to be current users of illicit substances. The higher prevalence of alcohol use among respondents may be more a characteristic of their socioeconomic class than of their profession. A unique concern for physicians, however, is their high rate of self-treatment with controlled medications--a practice that could increase their risk of drug abuse or dependence. Uniform national guidelines are needed to sensitize medical students and physicians to the dangers of self-treatment with controlled prescription substances.

Adult↗
PubMed1992

The stresses of the surgical residency.

UNLABELLED: Concern over resident work hours prompted us to study the stress of surgical residencies and determine if the experience might be associated with an increased use of alcohol and drugs. Two hundred fifty-seven surgery residents were selected from a stratified, randomized sample of residents (n = 1728) from the AMA files and were given an eight-page self-administered questionnaire. RESULTS: Surgical residents reported very long hours and heavy duties and complained of loss of sleep and exhaustion, both of which correlated with nights on call. Despite the heavier work load, surgical residents showed no more emotional stress than other residents. Surgery residents were more likely to have used alcohol in the last month than other residents (P less than .05) but 70% had used it fewer than 10 times in the month. All surgical residents were less likely to have used marijuana, cocaine, or other drugs than were other residents. Surgical residents seem to cope well with the extreme stresses of surgery training programs; however, more research needs to be done if we are to fully understand the process for training surgeons.

Alcohol Drinking↗
PubMed1992

Assessment of drug involvement: applications to a sample of physicians in training.

The investigators examined survey data of lifetime and recent drug use in national samples of 2036 senior medical students and 1772 resident physicians to test whether patterns of lifetime drug use could be characterized adequately by a single underlying dimension of 'drug involvement'. The data analysis was based on a two parameter normal item response theory (IRT) model using the marginal maximum likelihood estimation method. The results showed that a single latent dimension of 'drug involvement' characterized individual drug use differences on the following measures: substances ever used, substances used in the previous year or previous month, and the sequential order of first use for each substance. The dimension was equivalent for students and resident physicians, and for both genders. Those who professed 'no religion' tended to be more drug involved. Physicians-in-training with a higher drug involvement score based on lifetime use were more likely: (a) to have used higher-ranking drugs (such as LSD and prescription opiates) in the past year; and (b) to have used a greater number of different drugs during the past month. Subjects first began to use each of the substances in a relatively invariant sequence corresponding to that predicted by the model. The implications of this model for evaluating the drug use histories of physicians-in-training, for identifying subgroups at greater risk for continued drug involvement after the beginning of medical training, and for further psychological, biological, and sociocultural research on the nature of 'drug involvement' are discussed.

Adult↗
PubMed1992

Resident physician substance use, by specialty.

OBJECTIVE: This study compares substance use by medical specialty among resident physicians. METHOD: The authors estimated the prevalence of substance use of 11 medical specialties from a national sample of 1,754 U.S. resident physicians. RESULTS: Emergency medicine and psychiatry residents showed higher rates of substance use than residents in other specialties. Emergency medicine residents reported more current use of cocaine and marijuana, and psychiatry residents reported more current use of benzodiazepines and marijuana. Contrary to recent concerns, anesthesiology residents did not have high rates of substance use. Family/general practice, internal medicine, and obstetrics/gynecology were not among the higher or lower use groups for most substances. Surgeons had lower rates of substance use except for alcohol. Pediatric and pathology residents were least likely to be substance users. CONCLUSIONS: The authors' previous research indicates that residents overall have lower rates of substance use than their age peers in society. Yet resident substance use patterns do differ by specialty. Residents in some specialties are more likely to use specific classes of drugs, to use a greater number of drug classes, and to be daily users of alcohol or cigarettes.

Benzodiazepines↗
PubMed1991

Resident physician substance use in the United States.

A national survey was conducted to determine patterns of drug use among 3000 American resident physicians. Sixty percent (1785) of the residents surveyed responded. This report evaluates the prevalence of drug use among the respondents, when they initiated drug use, and their reasons for current use. Substance use rates are compared with other studies of resident physicians and with a sample of their nonphysician age peers surveyed the same year. Heavy substance use patterns were not observed among resident physicians. They had significantly lower rates of use for most psychoactive substances than their peers in the general population but did report higher rates of past-month use of alcohol and benzodiazepines. A sizable minority began using benzodiazepines and prescription opiates during their residency years-the stage in physicians' training when they first receive prescribing privileges. Current users of benzodiazepines and opiates used these drugs primarily for self-treatment rather than recreation. These two substances are often associated with impairment at later stages in the physician's career.

Adult↗
PubMed1991

Substance use among senior medical students. A survey of 23 medical schools.

Senior students at 23 regionally distributed medical schools received an anonymous questionnaire designed to examine current and prior use of tobacco, alcohol, and nine other drugs. The overall response rate was 67% (N = 2046). Substance use prevalence rates during the 30 days preceding the survey included alcohol, 87.5%; marijuana, 10.0%; cigarettes, 10.0%; cocaine, 2.8%; tranquilizers, 2.3%; opiates other than heroin, 1.1%; psychedelics other than LSD (lysergic acid diethylamide), 0.6%; amphetamines, 0.3%; barbiturates, 0.2%; LSD, 0.1%; and heroin, 0.0%. Compared with national, age-related comparison groups, senior medical students reported less use of all substances during the past 30 days and the past 12 months, except for alcohol, tranquilizers, and psychedelics other than LSD. Substantial new drug use after entry into medical school was reported only for tranquilizers. Seven students (0.2%) admitted to current dependence on a substance other than tobacco, four of these implicating marijuana. Thirty-three students (1.6%) believed that they currently needed help for substance abuse. Only 25.7% were aware of any policy on substance abuse at their own school.

Adult↗
PubMedDate not supplied

Workplace access, negative proscriptions, job strain, and substance use in registered nurses.

BACKGROUND: Both occupational conditions and individual factors have been shown as contributors to the likelihood of substance use among health professionals. OBJECTIVES: To assess the use of Winick's (1974) model for explaining nurses' substance use, which asserts that groups with access to substances, freedom from negative proscriptions, and role strain have an increased likelihood of drug dependence. METHODS: Data were analyzed from the 3,600 working nurses participating in the Nurses Worklife and Health Study, a nationally representative survey of registered nurses in the United States. A structural equation model was tested fitting workplace access to substances (availability, frequency of administration, and knowledge), freedom from negative proscriptions (internal: religiosity; external: social network), and role strain (job demands and depressive symptoms) to the frequency of past year alcohol, marijuana/cocaine, and prescription-type drug use. RESULTS: Nurses were more likely to use substances when workplace access to substances increased (p < 0.001), with social networks containing more drug users, and when religiosity decreased (p < 0.001). Role strain (measured through job demands and depressive symptoms) also was related to substance use. Depressive symptoms were related directly and negatively to substance use (p < 0.01), whereas job demands were related indirectly to substance use through depressive symptoms. CONCLUSIONS: Winick's model has use in explaining nurses' substance use. Research and preventive initiatives should consider the multidimensional aspects of substance use in nurses.

Adult↗