Background Problematic substance use (PSU) poses occupational, personal and professional risks. As an occupational group, midwives have been under-represented in research on PSU. Aims The aim of this study was to assess self-reported occurrences of PSU, help-seeking behaviours and barriers, and perceptions of impairment in UK-based midwives. Methods Self-selecting registered midwives were anonymously surveyed using the Tobacco, Alcohol, Prescription Medications, and Substance Use/Misuse (TAPS) tool, the Perceptions of Nursing Impairment Inventory (PNII) and open-ended/closed questions. Quantitative data were used to explore PSU, help-seeking and attitudes to impairment. Qualitative responses were used to provide richer understandings. Results From 623 completed surveys, 28% (n = 176) self-reported PSU in response to work-related stress and anxiety, bullying, traumatic clinical incidents and maintenance of overall functioning. PSU was related to alcohol and a range of restricted drugs. While 11% of those affected indicated they had sought help, 27% felt they should seek help but did not. Reported barriers to help-seeking included fear of repercussions, shame, stigma, practicalities and a perceived lack of support either available or required. Perceptions of impairment were predominantly compassionate with a minority of stigmatizing attitudes displayed. Conclusions Overall, 10% of the sample reported they had attended work under the influence of alcohol, and 6% under the influence of drugs other than tobacco or those as prescribed to them. Furthermore, 37% indicated concern about a colleague’s substance use. As stigmatizing attitudes and punitive actions can dissuade help-seeking, changed perceptions and policies which favour alternatives to discipline are suggested to reduce the risk overall.

中文翻译：

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有问题的物质使用：对助产士工作场所影响的评估

背景 问题物质使用 (PSU) 会带来职业、个人和职业风险。作为一个职业群体，助产士在 PSU 研究中的代表性不足。目的 本研究的目的是评估英国助产士自我报告的 PSU 发生率、求助行为和障碍，以及对损伤的看法。方法 使用烟草、酒精、处方药和物质使用/滥用 (TAPS) 工具、护理障碍量表 (PNII) 和开放式/封闭式问题对自选注册助产士进行匿名调查。定量数据用于探索 PSU、寻求帮助和对损伤的态度。定性回答被用来提供更丰富的理解。结果 在完成的 623 份调查中，28% (n = 176) 自我报告 PSU 以应对与工作相关的压力和焦虑，欺凌、创伤性临床事件和维持整体功能。PSU 与酒精和一系列受限药物有关。虽然 11% 的受影响者表示他们曾寻求帮助，但 27% 的人认为他们应该寻求帮助但没有寻求帮助。据报道，寻求帮助的障碍包括害怕受到影响、羞耻、耻辱、实用性以及缺乏可用或需要的支持。对损伤的看法主要是富有同情心的，少数表现出污名化的态度。结论 总体而言，10% 的样本报告说他们在酒精的影响下工作，6% 的人在使用烟草以外的药物或处方药的影响下工作。此外，37% 的人表示担心同事的物质使用。由于污名化的态度和惩罚性行为可以阻止寻求帮助，