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Associations between healthcare workers' substance use and quality of care: Findings from a one-year Swedish follow-up study

Year: 2025

Type: article

Abstract: BACKGROUND: Problem drinking and illicit drug use among healthcare workers (i.e., physicians and nurses) may impair their attention and cognitive functioning, thereby increasing the risk of medical errors and diminishing the quality of patient care. OBJECTIVE: To investigate the association between healthcare workers' problem drinking and illicit drug use with subsequent self-rated quality of care provided. DESIGN: A two-wave longitudinal observational study. METHODS: Panel data were drawn from the Longitudinal Occupational Health Survey in Healthcare Sweden (LOHHCS), collected in 2022 (baseline) and 2023 (follow-up), encompassing a sample of 3280 healthcare workers. Questionnaires included problem drinking, illicit drug use (cannabis and stimulants), and self-rated quality of care they provide to patients. Logistic regression models analysed relationships between the study variables. RESULTS: At baseline, the prevalence of problem drinking was 3.8 %, and illicit drug use was 1.3 %. Both problem drinking (OR = 1.93, 95 % CI = 1.28-3.02) and illicit drug use (OR = 2.07, 95 % CI = 1.00-4.29) were significantly associated with lower self-rated quality of care provided at follow-up, after adjustment for confounding variables. CONCLUSIONS: This novel longitudinal study shows that healthcare workers reporting substance use at baseline were about twice as likely to report providing poor quality of care one year later. These findings are of clinical relevance and highlight the need for targeted preventive measures and interventions to safeguard the health and well-being of healthcare workers while maintaining quality standards in patient care.

Source: International Journal of Nursing Studies

DOI: 10.1016/j.ijnurstu.2025.105276