The socio-demographics characteristics of the sample
The final sample consisted of 232 nurses/midwives (response rate was 46.4%). Among participants, sixty-seven (n = 67, 28.9%), were male and the other female (n = 165, 71.1%). The mean of age of the participants was 32.3 years (SD: 9.2; range: 21–70). The vast majority of them, were Cypriots (n = 202, 86.8%), while twelve (n = 12, 5.3%) of them were Greek and eighteen (n = 18, 7.9%) of the samples were foreigners. Among participants, the vast majority of them, were Christian Orthodox (n = 221, 95.3%), while the one hundred thirty-three (n = 136, 58.6%) of them argued as religious /very religious; additionally, 45.6% (n = 105) of sample were married. The majority were employed (n = 220, 94.8%), while 44.8% (n = 104) of them were working in government nursing positions. Most of them, were holders of undergraduate degree (n = 164, 72.9%), while 55 (n = 55, 23.7%) of the participants, were holders of master degree and only 9 (n = 9, 1.7%) of them were holders of a PhD degree. Most of them, have had more than 5 years work experience. The majority of the participants (n = 184, 79.2%) were General Practitioner Nurses, while 28 of them (n = 28, 12.1%) were Midwives, and 20 of them (n = 20, 8.7%), were Mental Health Nurses. (Table 1)
Table 1
The socio-demographics characteristics of the sample (n = 232)
Variables n(%)
|
Mean age = 32.30 (Range 21–70years / SD = 9.225)
|
Gender
|
|
Female
|
165 (71.1)
|
Male
|
67(28.9)
|
Religious
|
|
Christian
|
221 (95.3)
|
Muslim
|
1 (0.4)
|
Non-denominational / Atheist
|
6 (2.6)
|
Other
|
4(1.7)
|
Degree of loyalty
|
|
Not religious
|
19 (8.2)
|
Somewhat religious
|
77 (33.2)
|
Religious / Very religious
|
136 (58.6)
|
Mother born
|
|
Cyprus
|
202 (86.8)
|
Greece
|
12 (5.3)
|
Other European Countries
|
5 (2.2)
|
Soviet Union
|
7 (3.1)
|
Middle Eastern country
|
1 (0.4)
|
South America
|
1 (0.4)
|
Other
|
4 (1.8)
|
Family status
|
|
Single (not in a relationship)
|
51 (21.9)
|
Single (in a relationship)
|
62 (26.8)
|
Married / Civil partnership
|
105 (45.6)
|
Widow / Widower
|
1 (0.4)
|
Separated
|
1 (0.4)
|
Divorced
|
12 (4.9)
|
Government position nurse
|
|
Yes
|
104 (44.8)
|
No
|
128 (55.2)
|
Current employment status
|
|
Full-time / Part-time employed
|
220 (94.8)
|
Unemployed
|
12 (5.2)
|
Academic status
|
|
Undergraduate degree (BA, BS)
|
164 (72.9)
|
Master degree (MA, MS)
|
55 (23.7)
|
PhD
|
9 (1.7)
|
Other post graduate level degree
|
4 (1.7)
|
Work experience
|
|
0
|
11 (4.4)
|
1–2
|
37(15.8)
|
3–5
|
69 (29.8)
|
>5years
|
115 (50)
|
Study filed
|
|
Nurse
|
184 (79.2)
|
Midwife
|
28 (12.1)
|
Mental health nurse
|
20 (8.7)
|
Health Related Behaviors linked to Cannabis and MC among Greek-Cypriot Nurses/midwives and their relatives / friends
The results showed that, the vast majority of the participants (98.2%, n = 228) they have never used prescribed MC, while two (n = 4, 1.8%) of them, reported that they rarely used prescribed MC for personal purposes and finally, one of them (n = 1, 0.4%) has used monthly prescribed MC for personal purposes. Moreover, the participants (83.8%, n = 191) reported that denied the use of recreational marijuana, while the 13.6% (n = 31) reported that they have used recreational marijuana every month. Five of them (n = 5, 2.2%) reported that thy denied the use of recreational marijuana monthly and only one of them (n = 1, 0.4%) reported that, they denied the use of recreational marijuana weekly. Furthermore, a number of participant (7.9% n = 18), reported that they have a family member who uses/ had used MC, while thirteen (n = 13, 13.1%) reported that they have a family member who uses/had used recreational marijuana daily or weekly. Additionally, twenty-eight participants (12.3%, n = 28), reported that they have a friend or friends who uses/had used MC and another eighty-two (n = 82, 36.4%) of the participants reported that they have a friend/friends who uses/had used recreational marijuana daily or weekly.
Greek-Cypriot Nurses/midwives attitudes and Beliefs on cannabis and MC
The majority, of the participants strongly agreed with the assumption that health and welfare professionals should have formal training on the MC before recommending it to someone who is being treated (60.5%, n = 133), and stated that educational training in the use of MC should be integrated into the practice/clinical practice requirements of nurses (34.8%, n = 77). Additionally, participants stated that educational training for MC must be integrated into the academic programmes for the health and welfare professionals (46.1%, n = 107), and supported that Marijuana can be addictive (42.2%, n = 97). Participants also strongly agreed that additional research regarding MC use should be encouraged (58%, n = 134), and more than half supported that medical professionals who prescribe MC should have ongoing contact with their patients/clients (51.7%, n = 119). More than one third of them believed that physicians should recommend marijuana as medical therapy» (31.9%, n = 74) and stated that (37.2%, n = 86), they would recommend medical marijuana use to the patients if they could do it
Furthermore, the majority of the sample somewhat agreed with the assumption that using marijuana poses serious mental health risks (32.3%, n = 74) and almost the one third supported that they are aware of the benefits of MC (27%, n = 62). On the other hand, almost 4 in 10 of the participants agreed that, there are significant physical health benefits using MC, and almost 3 in 10 agreed that here are significant mental health benefits using MC. Finally, more than the one third of them (34.6%, n = 80) strongly disagreed that marijuana should be legalized for recreational use (Fig. 1).
According to nurses’ knowledge on MC use in specific disorders, in most of the questions, nurses reported that they don’t know if MC might be effective. Thus, they reported that MC is acceptable for persistent muscle spam (28.9%, n = 67), insomnia / sleeping disorders (26.7%, n = 62), mental health conditions (28%, n = 65), while they were strongly agreed that MC is strongly acceptable for terminal illness (20.3%, n=) (Fig. 2).
Greek-Cypriot Nurses/midwives attitudes and Beliefs on formal MC education
The participants reported that (41%, n = 94), were neutral on answering to a patient/client questions about medical marijuana, while most of the participants (55.9%, n = 128) strongly agreed and sixty-six of them (28.8%, n = 66) reported that nurses should receive formal education about medical marijuana law and regulations.
Greek-Cypriot Nurses’/midwives’ sources of information about MC
The majority of the participants (85.3%, n = 197) reported that they have never received any formal education about MC. Furthermore, the participants reported that students in their professional field should receive formal education about MC in class (31.6%, n = 73) and in clinical practice (11.3%, n = 26); more than half of them believed that (52.4%, n = 121) formal education about MC in class and in clinical practice is a must. Finally, the sample reported that, the most frequent sources of nurses’ information were medical literature (63.2%, n = 146), physicians (42%, n = 97), and experiences with patients / clients (42%, n = 97) (Fig. 3).
Differences on demographic characteristics among Greek-Cypriot Nurses/midwives on Medical Cannabis Attitudes Beliefs and Knowledge
Our results showed that male participants were more frequent to use cannabis for recreational purposes (p < 0.01, 26.8% vs. 13.4%) or even to have a friend who uses cannabis for recreational purposes (p < 0.05, 44.8% vs. 32.1%) compared with of female participants. Moreover, male participants agreed to healthcare professionals should have formal training about MC before recommending it to a patient (p < 0.05, 94% vs. 87.9%), while female participants were more frequent to agreed that «healthcare professionals who prescribe MC should have ongoing contact with their patients (p < 0.05, 96.7% vs. 85%). Furthermore, there was a statistically significant difference between gender and attitudes and beliefs on MC, where male participants were more frequent to believe that they are prepared to answer patient’s questions about MC than women participants (p < 0.01, 41.8% vs. 18.8%). In addition, male participants were more frequent to report that their main source of information on MC was through own personal use of MC (p < 0.05, 5.6% vs. 4.2%).
Moreover, the age group of 20–30 years old were more frequent to agree that additional research for MC must be integrated into academic programs in relation to age groups 31–40 years and ≥ 41 (p < 0.05, 98.6% vs. 88.4% and 86.7%), while the age groups of 20–30 years old and ≥ 41 years old were more frequent to agree that education training for MC must be integrated into academic programs in relation group 31–40 years (p < 0.05, 100% and 100% vs. 95.2%).
Furthermore, our results pointed out those participants who reported as non-denomination/ atheist as their religion were more frequent to report that they have friends who use cannabis. Specifically, participant who reported non-denomination / atheist and other religion were more frequent to agreed that educational training for MC must be integrated in relation Christian Orthodox (p < 0.05, 100% and 100% vs. 83.7%). Participants that reported to be Muslim were more frequent to agree that additional research regarding MC use should be encouraged (p < 0.05, 100% vs. 97.2% and 75% and 96.9%).
Finally, unmarried participants (p < 0.05, 22.7%) were more frequent to report that they used cannabis for recreational purposes. Specifically, unmarried people stated that, their friends used cannabis for recreational purposes compared with married participants (p < 0.05, 43.2% vs. 28.2%). Furthermore, unmarried participants were more frequent to agree that using cannabis poses serious mental health risks (p < 0.05, 77.3% vs. 66.7%), while their main source of information about MC was more often to be by other nurses (p < 0.05, 31.5% vs. 17.5%) compared with married participants. There was no statistically significant difference between work experience and nurses’ attitudes and beliefs (Table 2).
Table 2
Medical Cannabis Attitudes Beliefs and Knowledge among Greek-Cypriot Nurses (n = 232)
Gender % (n)
|
|
|
Total
n(232)
|
Male
(n = 67)
|
Female
(n = 165)
|
P value
|
Part A: Health-related behaviors linked to cannabis and medical cannabis
|
|
|
|
|
Personal use of cannabis for recreational
purposes.
|
17.2(40)
|
26.8(18)
|
13.4 (22)
|
**
|
Friends who use cannabis for recreational
purposes.
|
33.2(83)
|
44.8(30)
|
32.1(53)
|
*
|
Part B: Attitudes & beliefs on cannabis and medical cannabis (MC)
|
|
|
|
|
Healthcare professionals should have formal
training about MC before recommending it to
a patient.
|
89.7(208)
|
94(63)
|
87.9(145)
|
*
|
Healthcare professionals who prescribe MC
should have ongoing contact with their
patients.
|
93.5(217)
|
85(57)
|
96.7(160)
|
*
|
Part C: Attitudes & beliefs on medical cannabis education (MC)
|
|
|
|
|
I am prepared to answer patient’s questions
about MC.
|
25.4(59)
|
41.8(28)
|
18.8(31)
|
**
|
Part D: Sources of information about medical cannabis (MC)
|
|
|
|
|
Personal use
|
4.7(11)
|
5.6(4)
|
4.2(7)
|
*
|
*p < .05; **p < .01; ***p < .001
|
|
|
|
Age Group % (n)
|
|
Total
n(232)
|
20–30 years old(n = 144)
|
31–40 years old(n = 43)
|
≥ 41 years old(n = 45)
|
P value
|
Part B: Attitudes & beliefs on cannabis and medical cannabis (MC)
|
|
|
|
|
|
Additional research regarding MC use should
be encouraged.
|
94.4(219)
|
98.6(142)
|
88.4(38)
|
86.7(39)
|
*
|
Part C: Attitudes & beliefs on medical cannabis education (MC)
|
|
|
|
|
|
Educational training for MC must be
integrated into academic programs
|
98.7(229)
|
100(144)
|
95.2(40)
|
100(45)
|
*
|
|
|
Religion % (n)
|
|
Total
n(232)
|
Christian Orthodox
(n = 221)
|
Muslim
(n = 1)
|
Non denomination / Atheist(n = 6)
|
Other
(n = 4)
|
P value
|
Part A: Health-related behaviors linked to cannabis and medical cannabis
|
|
|
|
|
|
|
Friends who use any cannabis
|
12.1(28)
|
10.1(24)
|
-
|
33.3(2)
|
50(2)
|
*
|
Part B: Attitudes & beliefs on cannabis and medical cannabis (MC)
|
|
|
|
|
|
|
Educational training for MC must be
integrated into clinical practice
|
84.1(195)
|
83.7(185)
|
-
|
100(6)
|
100(4)
|
*
|
Additional research regarding MC use should
be encouraged.
|
94(218)
|
95.4(211)
|
100(1)
|
50(3)
|
75(3)
|
*
|
*p < .05; **p < .01; ***p < .001
Family Status % (n)
|
|
Total
(n = 232)
|
Married
(n = 105)
|
Unmarried
(n = 127)
|
P value
|
Part A: Health-related behaviors linked to cannabis and medical cannabis
|
|
|
|
|
Personal use of cannabis for recreational
purposes.
|
17.7(41)
|
11.4(12)
|
22.8(29)
|
*
|
Friends who use cannabis for recreational
purposes
|
35.6(83)
|
27.6(29)
|
42.5(54)
|
*
|
Part B: Attitudes & beliefs on cannabis and medical cannabis (MC)
|
|
|
|
|
Using cannabis poses serious mental health
risks
|
72(167)
|
66.8(68)
|
77.9(99)
|
*
|
Part E: Sources of information about medical cannabis (MC)
|
|
|
|
|
Other nurses
|
25(58)
|
17.1(18)
|
31.5(40)
|
*
|
*p < .05; **p < .01; ***p < .001
|
Differences on demographic characteristics among Greek-Cypriot Nurses/midwives concerning on MC used in the treatment of specific disorders
Evidences from our research showed that male participants were more frequent to report that MC is acceptable for the treatment of anorexia, HIV/AIDS, inflammatory bowel disease (e.g. Crohn’s disease), nausea and persistent muscle spasm (p < 0.05). Moreover, participants at the age group of 20–30 years old were more frequent to report that MC is acceptable for the treatment of nausea and/or vomiting due to cancer treatment, HIV/AIDS, mental health conditions (e.g. PTSD, depression, anxiety etc), multiple sclerosis, Parkinson’s disease and terminal illness (p < 0.05). Furthermore, participants at the age group of 31–40 years old reported that MC is acceptable for the treatment of eating disorders, insomnia / sleep disorders and nausea, while participants at the age group of > 41 years old were more frequent to report that MC is acceptable for seizure / epilepsy (p < 0.05). Participants who declared to be non-denomination / atheist were more frequent to report that MC is acceptable for the treatment of Alzheimer disease, eating disorders (egg. Anorexia), mental health conditions (egg. PTSD, depression, anxiety) (p < 0.050). finally, participants with 3–5 years of work experience reported that MC is acceptable for the treatment of nausea and/or vomiting due to cancer treatment and terminal illness (p < 0.05) (Table 3). The Cronbach’s alpha in the present study was 0.85.
Table 3
Nurses knowledge about MC in the treatment of specific disorders (n = 232)
|
Gender % (n)
|
|
|
Total
(n = 232)
|
Male
(n = 67)
|
Female
(n = 165)
|
P value
|
Anorexia
|
19(44)
|
33.8(22)
|
13.3(22)
|
*
|
HIV/AIDS
|
24.1(56)
|
28.3(19)
|
22.4(37)
|
**
|
Inflammatory bowel disease (eg. Crohn’s disease)
|
44.5(94)
|
44.8(30)
|
38.8(64)
|
*
|
Nausea
|
27.6(64)
|
37.3(25)
|
23.6(39)
|
*
|
Persistent muscle spasm
|
59.9(139)
|
59.7(40)
|
60(99)
|
*
|
|
Age % (n)
|
|
Total
(n = 232)
|
20–30 years old(n = 144)
|
31–40 years old(n = 43)
|
> 41 years old(n = 44)
|
P value
|
Nausea and/or vomiting due to cancer treatment
|
49.6(115)
|
53.5(77)
|
44.2(19)
|
43.2(19)
|
**
|
Eating disorders (eg. Anorexia)
|
31.9(74)
|
30.6(44)
|
34.8(15)
|
34.1(15)
|
**
|
HIV/AIDS
|
23.7(55)
|
25(36)
|
23.2(10)
|
20.5(9)
|
*
|
Insomnia / sleep disorders
|
59.1(137)
|
59(85)
|
60.5(26)
|
59.1(26)
|
*
|
Mental health conditions (eg. PTSD, depression, anxiety,etc)
|
66.4(154)
|
70.1(101)
|
55.8(24)
|
65.9(29)
|
*
|
Multiple Sclerosis
|
53.9(125)
|
58.3(84)
|
46.5(20)
|
47.7(21)
|
*
|
Nausea
|
27.6(64)
|
23.6(34)
|
38.9(15)
|
34.1(15)
|
***
|
Parkinson’s disease
|
40.9(95)
|
42.4(61)
|
37.2(16)
|
40.9(18)
|
*
|
Seizure / Epilepsy
|
47.4(110)
|
47.9(69)
|
44.2(19)
|
50(22)
|
*
|
Terminal illness
|
72.8(169)
|
80.6(116)
|
69.8(30)
|
59.1(26)
|
**
|
|
|
Religion % (n)
|
|
Total
(n = 232)
|
Christian Orthodox
(n = 221)
|
Muslim
(n = 1)
|
Non denomination / Atheist
(n = 6)
|
Other
(n = 4)
|
P value
|
Alzheimer’s disease
|
42.7(99)
|
41.2(91)
|
-
|
100(6)
|
50(2)
|
*
|
Eating disorders (eg. Anorexia)
|
31.9(74)
|
33(73)
|
-
|
16.7(1)
|
-
|
*
|
Mental Health conditions (eg. Depression, anxiety, etc.)
|
66.8(155)
|
67(148)
|
-
|
100(6)
|
25(1)
|
**
|
|
Work Experience % (n)
|
|
Total
(n = 232)
|
0 years
(n = 11)
|
1–2 years
(n = 37)
|
3–5 years
(n = 69)
|
> 5years
(n = 115)
|
P value
|
Nausea and/or vomiting due to cancer treatment
|
49.6(115)
|
45.5(5)
|
37.8(14)
|
55.1(38)
|
50.4(58)
|
*
|
Terminal illness
|
74.1(172)
|
63.6(7)
|
72.8(27)
|
88.4(61)
|
67(77)
|
*
|
*p < .05; **p < .01; ***p < .001
|
|
|
|
|
|
|