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Zeng Y, Pan T, Sun M. The influencing factors of stigma towards people with mental illness among nursing students: a mixed-method systematic review. MEDICAL EDUCATION ONLINE 2024; 29:2376802. [PMID: 38970824 PMCID: PMC11229721 DOI: 10.1080/10872981.2024.2376802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
The stigma of nursing students towards people with mental illness (PMI) creates significant barriers to diagnosis, treatment, and recovery for those with PMI. It can also have a significant impact on the future career choices of nursing students in the field of psychiatry. Current research has found various influencing factors, including personal characteristics and educational influences. However, a comprehensive analysis that encompasses all aspects is lacking. The aim of the study was to conduct a convergent mixed-method systematic review to synthesize the influencing factors of the stigma of nursing students towards PMI according to Framework Integrating Normative Influences on Stigma (FINIS) at micro, meso, and macro levels. PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO were searched from 1990 to 31 December 2023. The reference lists of the included literature were further checked to identify potentially relevant articles. Two authors independently screened all titles, abstracts, and full-text articles and extracted data. Study quality was assessed by two authors using the Mixed Method Appraisal Tool (MMAT). A total of 4865 articles were initially retrieved, and 73 of these articles were included. The results suggested that the stigma towards PMI by nursing students was influenced by micro, meso and macro levels. At each FINIS level, the most frequent influencing factors are personal characteristics, the treatment system and media images. Numerous interconnected factors exert an influence on the stigma towards PMI among nursing students. Our research can be used to identify barriers and facilitators to nursing students' stigma towards PMI and to provide supporting information for interventions designed to reduce this stigma.
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Affiliation(s)
- Yi Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Changsha Medical University, Changsha, China
| | - Ting Pan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Xinjiang Medical University, Urumqi City, China
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Ben Natan M, Gharra A, Faduos B, Magadlah A, Biadsy A. Examining the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing: A comparative analysis of generic and accelerated programs in Israel. J Psychiatr Ment Health Nurs 2024; 31:815-824. [PMID: 38375931 DOI: 10.1111/jpm.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 02/21/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental health nursing is generally viewed as the least attractive career choice among nursing students. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Studying in the generic nursing program influence higher desire for a career in mental health nursing. Nursing students who have prior experience working in mental health and have provided care to psychiatric patients are more inclined to express a desire to pursue a career in this field WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing students enrolled in the generic program, who have previous work experience in mental health or experience caring for a person with a mental illness, and who have a lower level of stigmatizing attitudes, may constitute the future workforce in mental health nursing. ABSTRACT INTRODUCTION: Mental health nursing is often perceived as an unattractive career choice among nursing students, and it remains unclear whether the type of nursing program influences this view. AIM This cross-sectional study aimed to explore the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing, comparing students in generic and accelerated programs. METHOD A total of 220 nursing students from generic and accelerated programs in North-Center Israel participated in this cross-sectional study, completing a questionnaire on stigmatizing attitudes and their interest in a mental health nursing career. RESULTS Nursing students displayed a generally low desire for mental health nursing, influenced by factors such as enrollment in the generic program, previous mental health work experience and stigmatizing attitudes. DISCUSSION Students in the generic program, with lower stigmatizing attitudes and prior mental health experience, exhibited a higher inclination towards mental health nursing. IMPLICATIONS FOR PRACTICE Prospective mental health nursing professionals may be identified in the generic program, particularly those with prior mental health experience and lower stigmatizing attitudes. Additional studies are required to confirm and broaden their applicability to other contexts.
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Affiliation(s)
- Merav Ben Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, Sackler Faculty of Medicine, Steyer School of Health Professions, General Nursing Degree Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Adam Gharra
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, Sackler Faculty of Medicine, Steyer School of Health Professions, General Nursing Degree Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Baher Faduos
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, Sackler Faculty of Medicine, Steyer School of Health Professions, General Nursing Degree Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Abedallah Magadlah
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, Sackler Faculty of Medicine, Steyer School of Health Professions, General Nursing Degree Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Abedalrahman Biadsy
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, Sackler Faculty of Medicine, Steyer School of Health Professions, General Nursing Degree Program, Tel Aviv University, Tel Aviv-Yafo, Israel
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Richards SJ, O'Connell KA, Dickinson JK. Decreasing Prejudicial Attitudes of Fear and Avoidance Toward Those Who Live with a Mental Illness-A Quasi-Experimental Controlled Study. Issues Ment Health Nurs 2024; 45:724-733. [PMID: 38776548 DOI: 10.1080/01612840.2024.2346593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The undergraduate mental health nursing course is an optimal time to address stigma and prejudice, while developing positive student attitudes toward those who live with mental health conditions. A quasi-experimental, pretest-posttest, nonequivalent-group study with a sample of undergraduate nursing students in New York City (N = 126) was conducted to determine the impact of an undergraduate mental health nursing course on attitudes toward people living with a general mental illness, depression, or schizophrenia. The intervention resulted in a significant reduction in total prejudice scores toward those with a general mental illness when compared to the control (p = 0.033, partial η2 = 0.062). The intervention had no significant impact on total prejudice scores regarding those with depression, or schizophrenia. Subscale analysis revealed the intervention significantly reduced attitudes of fear/avoidance regarding general mental illness (p = 0.040, partial η2 = 0.058) and schizophrenia (p < 0.001, partial η2 = 0.164). There was no impact on authoritarian or malevolent attitudes. Though some attitudes were not amenable to change, this study provides evidence that positive attitudes can be cultivated through undergraduate nursing education. Curricular reform is needed to reduce all facets of prejudice and best prepare future nurses to care for those with mental health conditions.
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Mahsoon A, Alnakli M, Azab S, Abed M, Aabduqader A, Sharif L, Sharif K. Nursing Students' Attitudes toward Working in Mental Health Facilities in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1168. [PMID: 38921283 PMCID: PMC11202738 DOI: 10.3390/healthcare12121168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: There is a global demand for more psychiatric nurses, with nursing students' attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health facilities among undergraduate nursing students in Saudi Arabia, both before and after exposure to psychiatry courses, and examine their relationship with perceptions of mental illness. (2) Methods: A quantitative descriptive and correlational cross-sectional design was employed. Nursing students' attitudes toward working in mental health facilities were assessed using the Attitude Toward Psychiatry 18 (ATP-18) questionnaire and the Beliefs Toward Mental Illness (BMI) scale. (3) Results: No significant relationship has been found between the frequency of negative views of both ATP-18 and BMI, and exposure to the psychiatry course. However, nurses who completed the psychiatry course held more positive views towards psychiatrists and found psychiatric patients less demanding, were less likely to view psychological disorders as dangerous, more confident in trusting mentally ill colleagues, and felt less embarrassed by the term "psychological disorder" compared to those who had not taken the course. (4) Conclusion: Based on our findings, it is evident that exposure to psychiatric courses and training enhances the potential of nursing students to contribute effectively to the psychiatric field. Therefore, integrating mental health and illness community services training into nursing education programs can play a pivotal role in raising awareness and attracting students who may hold negative attitudes towards individuals with mental illness.
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Affiliation(s)
- Alaa Mahsoon
- Psychiatric and Mental Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Mortada Alnakli
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.); (S.A.); (M.A.); (A.A.)
| | - Sameer Azab
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.); (S.A.); (M.A.); (A.A.)
| | - Majd Abed
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.); (S.A.); (M.A.); (A.A.)
| | - Abdulaziz Aabduqader
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.); (S.A.); (M.A.); (A.A.)
| | - Loujain Sharif
- Psychiatric and Mental Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Khalid Sharif
- Geriatric and Adult Psychiatrist, King Fahad Armed Forces Hospital (KFAFH), Jeddah 23311, Saudi Arabia;
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Guerrero Z, Iruretagoyena B, Parry S, Henderson C. Anti-stigma advocacy for health professionals: a systematic review. J Ment Health 2024; 33:394-414. [PMID: 36919957 PMCID: PMC10173949 DOI: 10.1080/09638237.2023.2182421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/21/2022] [Accepted: 11/14/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Many anti-stigma programs for healthcare workers already exist however there is less research on the effectiveness of training in skills for health professionals to counter stigma and its impacts on patients. AIMS The objective of this study was to examine the theory base, content, delivery, and outcomes of interventions for healthcare professionals which aim to equip them with knowledge and skills to aid patients to mitigate stigma and discrimination and their health impacts. METHODS Five electronic databases and grey literature were searched. Data were screened by two independent reviewers, conflicts were discussed. Quality appraisal was realized using the ICROMS tool. A narrative synthesis was carried out. RESULTS The final number of studies was 41. In terms of theory base, there are three strands - responsibility as part of the professional role, correction of wrongful practices, and collaboration with local communities. Content focusses either on specific groups experiencing health-related stigma or health advocacy in general. CONCLUSIONS Findings suggest programs should link definitions of stigma to the role of the professional. They should be developed following a situational analysis and include people with lived experience. Training should use interactive delivery methods. Evaluation should include follow-up times that allow examination of behavioural change. PROSPERO, ID: CRD42020212527.
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Affiliation(s)
- Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Barbara Iruretagoyena
- Department of Neurology and Psychiatry, Clínica Alemana Universidad del Desarrollo, Las Condes, Chile
| | - Sarah Parry
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Claire Henderson
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Health Service and Population Research, King’s College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Khazaee-Pool M, Naghibi SA, Pashaei T, Ponnet K. Developing practical strategies to reduce addiction-related stigma and discrimination in public addiction treatment centers: a mixed-methods study protocol. Addict Sci Clin Pract 2024; 19:40. [PMID: 38755676 PMCID: PMC11097512 DOI: 10.1186/s13722-024-00472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND People with substance use disorders (SUDs) have restricted engagement with health-care facilities and describe repeated experiences of stigma, discrimination, and mistreatment when receiving care at health-care and public addiction treatment centers (PATCs). The purpose of the current study is to design practical cultural-based strategies to reduce addiction-related stigma and discrimination at PATCs. METHODS/DESIGN The present study will use a mixed-methods design with an explanatory sequential approach. Phase 1 of the study will combine a cluster sampling technique combined with a cross-sectional survey of Patients with Substance Use Disorders (SUDs) in Mazandaran, Iran. A total of three hundred and sixty individuals with SUDs will be selected to assess their experiences of stigma and factors predicting stigma. Phase 2 will involve qualitative study aimed at exploring participants' perceptions regarding the aspects and determinants of their stigma experience. The participants will include two groups: people with SUDs and staff/health-care providers at PATCs. Participants for Phase 2 will be purposively sampled from those involved in Phase 1.Qualitative data will be collected using in-depth semi-structured interviews and focus group discussions and analyzed using content analysis with a conventional approach. Phase 3 will focus on the development of new strategies to reduce the experiences of stigma among people with SUDs at PATCs. These strategies will be formulated based on the findings derived from the qualitative and quantitative data obtained in Phases 1 and 2, a comprehensive review of the literature, and expert opinions gathered using the nominal group technique. DISCUSSION This is one of the few studies conducted within the domain of stigma pertaining to individuals who use drugs within the context of Iranian culture employing a mixed-methods approach, this study aims to develop culturally sensitive strategies to reduce such problems from the perspective of Iranian people who use drugs. It is anticipated that the study will yield evidence-based insights and provide practical strategies to reduce the stigma and discrimination experienced by people who use drugs at PATCs. Such outcomes are important for informing policymaking and designing healthcare interventions tailored to the needs of individuals grappling with substance dependency.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Health Education and Promotion, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Seyed Abolhassan Naghibi
- Department of Health Education and Promotion, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Pashaei
- Department of Health Promotion and Education, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Koen Ponnet
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
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Amit-Aharon A, Warshawski S. Sophomore nursing students' perception of their Professional Behavior toward Rehabilitation patients: a cross-sectional study. BMC Nurs 2023; 22:443. [PMID: 37993851 PMCID: PMC10666364 DOI: 10.1186/s12912-023-01616-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/20/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Rehabilitation is considered one of the elements of universal health coverage, emphasizing its importance for every person in need throughout the life course. Nurses play a pivotal role in the rehabilitation team as they possess the competencies to help individuals manage health problems and maximize potential well-being. Yet, little is known regarding knowledge of this subject among nursing students, as well as regarding their attitudes, thoughts, and professional behavior. This study aimed to explore: (a) Sophomore students' attitudes, feelings, thoughts, and professional behavior toward rehabilitation patients; and (b) Differences in the research variables as affected by students' previous exposure to rehabilitation patients. METHODS A cross-sectional survey design among sophomore nursing students. A questionnaire was distributed through a commercial internet survey provider (Qualtrics.com) before the beginning of a mandatory course on "nursing rehabilitation", introduced for the first time in 2022 in all Israeli universities. Students were divided into three groups according to their previous exposure to rehabilitation patients: no professional or personal previous exposure to rehabilitation patients; previous professional or personal exposure to rehabilitation patients; and previous exposure to rehabilitation patients both in one's professional and personal life. The study adhered to the STROBE guidelines. RESULTS The sample consisted of 122 participants. Significant differences were found between the groups by their previous exposure to rehabilitation patients. Participants with no previous exposure to rehabilitation patients were found to have lower self-perceived capability to care for rehabilitation patients and more negative professional behavior toward rehabilitation patients and their families compared to the other two groups (H = 22.06, p = 0.006, H = 23.86, p = 0.03, respectively). No other statistical differences were observed between the groups. CONCLUSIONS The findings emphasize the importance of exposing students to the field of nursing rehabilitation and to the care of rehabilitation patients. Exposure to nursing rehabilitation specifically during one's studies, through theoretical learning and clinical experience, can promote positive attitudes, professional values, and positive professional behavior toward these patients and their families.
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Affiliation(s)
- Anat Amit-Aharon
- Department of Nursing, Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigalit Warshawski
- Department of Nursing, Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Roach A, Tadesse R. "It Is OK Not to Be OK": Nursing Students' Backgrounds and Perceptions of Mental Health Stigma and Implications for Mental Health Nursing Education. Issues Ment Health Nurs 2023; 44:1050-1058. [PMID: 37851476 DOI: 10.1080/01612840.2023.2265470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
There has been a notable increase in reported mental illnesses in recent years. Although mental illness is being discussed more openly, stigma toward mental illness still exists. Stigma can result in inadequate care for people with mental illnesses. Students come into nursing from a variety of backgrounds and these backgrounds influence their nursing clinical judgments, especially related to caring for people with mental illnesses. A qualitative descriptive analysis was conducted using 60 undergraduate nursing student reflections on their backgrounds and perceptions of mental health stigma. Students wrote about their Previously Held Beliefs and the Influence of Culture, Overcoming Stigma through their Experiences with Friends and Family, Influence of Popular Culture, and Personal Experiences, and their New Understanding of mental illness and what that means for their future nursing practice. These findings have important implications for nursing education including providing more opportunities for nursing students to care for people with mental illnesses, reframing how mental health content is delivered in undergraduate nursing programs, and providing additional support for students with personal mental illnesses.
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Affiliation(s)
- Ashley Roach
- Oregon Health & Science University School of Nursing, Portland, Oregon, USA
| | - Ruth Tadesse
- Oregon Health & Science University School of Nursing, Portland, Oregon, USA
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Richards SJ, O'Connell KA, Dickinson JK. Acknowledging Stigma: Levels of Prejudice among Undergraduate Nursing Students toward People Living with a Mental Illness-A Quasi-Experimental Single-Group Study. Issues Ment Health Nurs 2023; 44:778-786. [PMID: 37459622 DOI: 10.1080/01612840.2023.2229438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
INTRODUCTION The undergraduate mental health nursing course may be an optimal time to cultivate students' positive attitudes toward people living with a mental illness. AIM To determine the impact of an undergraduate mental health nursing course on students' attitudes toward people living with a mental illness, depression, and schizophrenia. METHOD A quasi-experimental single-group pretest posttest study was conducted using a sample of undergraduate nursing students in New York City (N = 44). Self-reported measures of prejudice toward those living with a mental illness were collected at the beginning of a mental health nursing course and again at its conclusion. RESULTS A statistically significant decrease in prejudice scores was found concerning mental illness (p = .03, d = 0.23), depression (p = .01, d = 0.31), and schizophrenia (p = .013, d = 0.34). Subscale analysis revealed significant decreases in the fear/avoidance and unpredictability subscales. Yet no significant change was found in the subscales of authoritarianism and malevolence for any of the three conditions. DISCUSSION A mental health course led to a modest decrease in prejudice. However, certain facets of prejudice remain unchanged. IMPLICATIONS FOR PRACTICE Major curricular reform is needed to optimize the impact of undergraduate nursing education.
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Affiliation(s)
| | | | - Jane K Dickinson
- Teachers College Columbia University, New York City, New York, USA
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10
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An International Multicenter Mental Health Standardized Patient Simulation on Nursing Students’ Beliefs Toward Mental Health Conditions. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Al Ma'ani MAQM, Hamaideh SH, Hamdan‐Mansour AM. The effect of a contact-based intervention on attitudes and intended behaviors of nursing students toward people with mental illness: A quasi-experimental study. Health Sci Rep 2022; 5:e954. [PMID: 36447567 PMCID: PMC9695080 DOI: 10.1002/hsr2.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 11/26/2022] Open
Abstract
Background and Aim Although nursing students are professionally and ethically trained and educated to respect patients with a variety of medical and mental problems, they continue to exhibit negative attitudes and behaviors toward mental disease and patients with mental illness. The accumulated evidence indicates that contact-based intervention (CBI) is helpful in enhancing nursing students' attitudes and behaviors toward patients with mental illness. Although evidence found to support the CBI, culture and settings might play a significant role to decide its effectiveness. This would call for testing further the effectiveness of CBI across cultures and healthcare settings. The purpose of this study was to assess the effect of a CBI on the attitudes and intended behaviors of nursing students in Jordan toward people with mental illness. Methods A quasi-experimental, pre-post, design was used. Data were collected from 81 nursing students from two nursing schools implementing the CBI using self-reported questionnaires to measure students' attitudes and intended behaviors toward people with mental illness. Data were collected during the first semester of the academic year 2019/2020. The paired-samples and independent-samples t tests were used to test the study's hypotheses. Results At baseline, the results indicated that there were no statistically significant differences between the experimental and control groups in terms of their attitudes and intended behaviors toward people with mental illness. At posttest, statistically significant improvements in the attitudes and intended behaviors of nursing students found in the experimental group and between control and experimental groups toward people with mental illness compared with baseline pretest measures (p < 0.001). Conclusion The CBI did improve the attitudes and intended behaviors of Jordanian nursing students toward people with mental illness. Significant implications for nurses were discussed.
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Affiliation(s)
| | - Shaher H. Hamaideh
- Community and Mental Health Nursing Department, Faculty of NursingThe Hashemite UniversityZarqaJordan
| | - Ayman M. Hamdan‐Mansour
- Community Health Nursing Department, Psychiatric Nursing, School of NursingThe University of JordanAmmanJordan
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Green G, Blau A, Reicher S. Nursing students' beliefs about mental health, interest in work, and job tendencies. Perspect Psychiatr Care 2022; 58:1476-1483. [PMID: 34591316 DOI: 10.1111/ppc.12952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/28/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To explore nursing students' mental health educational level, mental illness beliefs, and interest in working in mental health. DESIGN AND METHODS Descriptive research conducted with 173 nursing students which convenience sampled. The questionnaire was composed of mental illness beliefs, interest in working in mental health, and tendency to work in nursing areas. FINDINGS Main finding demonstarted perception of dangerous from mental illness related to low interest in working in mental health regarding all nursing students. PRACTICE IMPLICATIONS There is a necessity to discuss mental health beliefs within theoretical and practical learning as it may eventually can contribute to the quality of care and improve the image of mental healthcare.
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Affiliation(s)
- Gizell Green
- Department of Nursing, Ariel University, Ariel, Israel
| | - Ayala Blau
- Department of Nursing, Ariel University, Ariel, Israel
| | - Sima Reicher
- Department of Nursing, Ariel University, Ariel, Israel
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Wenzel C, Melrose S, Lane A, Kent-Wilkinson A. Clinical instruction in mental health nursing: students' perceptions of best practices. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2021-0147. [PMID: 35436393 DOI: 10.1515/ijnes-2021-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Negative clinical educational experiences for student nurses are predictors of negative attitudes and perceptions towards mental health. In clinical education, instructors take on this important role often with little to no formal training. This study explored nursing students' perceptions of instructional best practices in mental health clinical education. METHODS A qualitative descriptive design was used, and 10 Canadian baccalaureate nursing (BN) students were interviewed. These students had completed a six-week practicum on an acute inpatient psychiatric unit in either their second, third or fourth year of study. RESULTS Through thematic analysis, three themes were identified: (1) Students valued feeling prepared at the beginning of the clinical placement. (2) Students felt empowered when instructors encouraged self-direction. (3) Students appreciated positive role modeling by their instructors. CONCLUSIONS Suggestions for clinical teaching strategies are made to mitigate student stress, increase confidence, and address the influence of mental health stigma on learning.
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Affiliation(s)
| | - Sherri Melrose
- Athabasca University, Faculty of Health Disciplines, Athabasca, AB, Canada
| | - Annette Lane
- Athabasca University, Faculty of Health Disciplines, Athabasca, AB, Canada
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Martínez-Martínez C, Esteve-Claramunt F, Prieto-Callejero B, Ramos-Pichardo JD. Stigma towards Mental Disorders among Nursing Students and Professionals: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031839. [PMID: 35162862 PMCID: PMC8835101 DOI: 10.3390/ijerph19031839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/25/2023]
Abstract
Stigma is one of the main barriers to prevention, treatment and recovery from mental illness. However, bibliometric studies in this area are still scarce. Therefore, our aim was to quantify and analyze the scientific literature on the stigma of nursing students and professionals towards mental disorders. To this purpose, bibliometric indicators of scientific production, impact and collaboration were used. Among our results, it stands out that only 14.3% of the total number of studies analyzed measure the efficacy of the interventions carried out to reduce stigma. Furthermore, with exceptions such as Happell B and Byrne L, collaborations between authors and institutions are limited. “Service user involvement” appeared as a prominent keyword in 2018, coinciding with the increase in publications on the effectiveness of interventions. Interventions based on the involvement of people with psychiatric diagnoses in the design of nursing curricula seem to become a promising line of research. More studies measuring the efficacy of such interventions are needed. Knowledge of the lines of research that are being developed and of the researchers and institutions involved can contribute to creating synergy between the different researchers and to continue adding projects to the existing ones, thus contributing to the generation of more robust results that show the most indicated interventions to reduce the still present stigma and improve care for people with psychiatric diagnoses.
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Affiliation(s)
| | - Francisca Esteve-Claramunt
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain;
- Correspondence:
| | - Blanca Prieto-Callejero
- Nursing Department, University of Huelva, 21004 Huelva, Spain; (B.P.-C.); (J.D.R.-P.)
- Hospital Virgen de la Bella (Lepe), 21440 Huelva, Spain
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Treloar AE, Bleus K. Conceptualising Recovery in Mental Health Nursing: A Word, A Journey or A Philosophy of Nursing Care? JOURNAL OF PROBLEM-BASED LEARNING 2021. [DOI: 10.24313/jpbl.2021.00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: It is important for undergraduate mental health nursing students to develop an understanding of what recovery means in contemporary mental health nursing in order to practise in accordance with current models of care. However this concept can prove challenging for some. This paper looks at one particular undergraduate mental health nursing course with the aim of evaluating how effectively recovery is embedded in the course. Methods: Course material related to recovery and possible barriers to understanding of recovery, including both those contained in this particular undergraduate mental health nursing course and those which come from external factors, are discussed. Results: Ways to promote a better understanding of recovery-oriented mental health nursing care are suggested. Conclusions: To promote a greater understanding of recovery in mental health nursing there needs to be a better match between the consumer experience, educational materials provided in the course, tutor perspectives, student focus and assessment methods.
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Şengün İnan F, Günüşen N, Çelik İnce S, Çetinkaya Duman Z. The effect of a peer education program on nursing students' beliefs toward mental illnesses and their career choices. Perspect Psychiatr Care 2021; 57:1774-1781. [PMID: 33665824 DOI: 10.1111/ppc.12748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/30/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the effect of a peer education program on nursing students' beliefs toward mental illnesses and their career choices. DESIGN AND METHODS: This one-group quasi-experimental study was conducted with 95 undergraduate nursing students. FINDINGS The peer education program positively affected nursing students' beliefs toward mental illnesses (p < 0.005). It was determined that the students preferred psychiatric nursing more as a career field after the peer education program. PRACTICE IMPLICATIONS: Peer education programs may be a part of the nursing curriculum in combating stigma toward mental illnesses.
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Affiliation(s)
- Figen Şengün İnan
- Department of Psychiatric Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey
| | - Neslihan Günüşen
- Department of Psychiatric Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey
| | - Sevecen Çelik İnce
- Department of Nursing, Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Zekiye Çetinkaya Duman
- Department of Psychiatric Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey
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Gu L, Xu D, Yu M. Mediating effects of stigma on the relationship between contact and willingness to care for people with mental illness among nursing students. NURSE EDUCATION TODAY 2021; 103:104973. [PMID: 34049122 DOI: 10.1016/j.nedt.2021.104973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/06/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have demonstrated that contact positively impacts nursing students' willingness to care for people with mental illness. However, studies that have explored the mechanism of such a relationship between contact and willingness remain few. OBJECTIVES To examine the direct relationship between contact and nursing students' willingness to care for people with mental illness and to explore the potential mediating roles of stigma. DESIGN This was a cross-sectional study design. SETTINGS The study was conducted in a nursing school in Nanjing city, China. PARTICIPANTS A total of 839 nursing students were recruited in the study through convenience sampling. METHODS Nursing students' stigma, contact, and willingness to care for people with mental illness were measured online through the Stigma toward People with Mental Illness Scale (SPMI), the Level of Contact Report, and one item of "which degree indicates your willingness to provide care for people with mental illness," respectively. The structural equation model was applied to explore the potential mediating roles of stigma. RESULTS Contact with people suffering from mental illness directly affected nursing students' willingness to care for them (β = 0.076, p < 0.05). Meanwhile, stigma partly mediated the effect of students' contact on willingness to care for people with mental illness (β = 0.048, p < 0.05). CONCLUSIONS High level of contact can improve nursing students' willingness to care and the relationship is partly mediated by stigma. Measures to improve the level of contact and reduce stigmatizing attitudes of nursing students are accordingly essential in influencing them to have more willingness to care for people with mental illness.
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Affiliation(s)
- Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing 210023, China.
| | - Deguo Xu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing 210023, China.
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, China.
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Evaluation of the Use of Diverse Mental Health Simulation in Nursing Students' Learning Experience: An International Multisite Study. Nurse Educ 2021; 46:E148-E153. [PMID: 33882530 DOI: 10.1097/nne.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simulated patients (SPs) in mental health nursing education provide a unique approach to assist student development in complex assessment skills. PURPOSE The purpose of this international multisite study was to evaluate the use of two diverse mental health SP simulation scenarios on nursing students' satisfaction and self-confidence in learning to care for patients with mental health disorders in the United States (n = 70) and Turkey (n = 90). METHODS A multisite cross-sectional study design was used. Outcome measures included the Student Satisfaction and Self-confidence in Learning Scale and the adapted Simulation Effectiveness Tool-Modified. Results were analyzed using independent t tests. RESULTS While students in the United States reported higher perceived self-confidence and satisfaction in learning, both student populations found the intervention effective to their learning (P < .05). CONCLUSION Using SPs in mental health education allow students to practice their assessment skills learned in classroom and transfer them to the clinical area.
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Gu L, Jiao W, Xia H, Yu M. Psychiatric-mental health education with integrated role-play and real-world contact can reduce the stigma of nursing students towards people with mental illness. Nurse Educ Pract 2021; 52:103009. [PMID: 33735744 DOI: 10.1016/j.nepr.2021.103009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
Stigma and negative attitudes towards people with mental illness are frequently found among nursing students. Interventions targeting mental illness stigma are the critical elements in altering the status. The aim of the present study was to examine the effects of the psychiatric-mental health education with role-play and real-world contact on stigma of nursing students towards people with mental illness in China. A single group pretest and posttest study design was adopted and total 373 students were recruited whilst 343 completed the course. We integrated the role-play and contact with patients in the routine psychiatric-mental health education. After the education was completed, the students' stigma towards people with mental illness were positively changed (pretest mean score of stigma: 53.77, posttest mean score of stigma: 49.01, 95% CI: 2.63-6.87) and their willingness to care for the people with mental illness was also significantly increased (pretest mean score of willingness: 5.45, posttest mean score of willingness: 7.38, 95% CI: -2.22--1.65). The psychiatric-mental health education especially with integrated role-play and real-world contact is an effective way to reduce nursing students' stigma and negative attitudes towards people with mental illness and increases their willingness to care for people with mental illness.
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Affiliation(s)
- Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, 210023, China.
| | - Wenjuan Jiao
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, 210023, China.
| | - Haozhi Xia
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, 210023, China.
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, China.
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Rodríguez-Rivas ME, Cangas AJ, Fuentes-Olavarría D. Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders. Front Psychiatry 2021; 12:632252. [PMID: 33633613 PMCID: PMC7900522 DOI: 10.3389/fpsyt.2021.632252] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/20/2021] [Indexed: 01/28/2023] Open
Abstract
Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p < 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p < 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.
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Affiliation(s)
| | - Adolfo J Cangas
- Department of Psychology, University of Almería, Almería, Spain
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21
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Bujold A, Pariseau-Legault P, de Montigny F. [The unpopularity of mental health/psychiatry care settings among nursing students: A systematic review]. Rech Soins Infirm 2020; 141:17-37. [PMID: 32988187 DOI: 10.3917/rsi.141.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In every population and country around the world, mental health needs are great and are on the rise. Through their training and their vast field of expertise, nurses are an important lever for addressing the issue of accessibility in these care settings. While the increase in the number of new nursing graduates should have helped this issue, recent data show a sharp increase in the shortage of nurses in these care settings. This systematic review (n=40) using the CINAHL, MEDLINE, PsycArticles, and Scopus databases aims to explore why psychiatric and mental health care settings are unpopular with the next generation of nurses. Guided by Parse's theory, this review identifies three major themes : (1) nursing students' perspectives on mental health issues, (2) the influences of educational interventions on these perspectives, and (3) the factors facilitating and constraining a career in these care settings for new nursing graduates. These results enable a better understanding of what can affect the recruitment of new graduate nurses in mental health/psychiatry, while proposing various levers of intervention to specifically address this issue.
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O'Ferrall-González C, Almenara-Barrios J, García-Carretero MÁ, Salazar-Couso A, Almenara-Abellán JL, Lagares-Franco C. Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students. J Psychiatr Ment Health Nurs 2020; 27:237-245. [PMID: 31663221 DOI: 10.1111/jpm.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/28/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.
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Affiliation(s)
- Cristina O'Ferrall-González
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain.,Research Group PAIDI CTS-391, University of Cádiz, Cádiz, Spain
| | - José Almenara-Barrios
- Department of Biomedicine, Biotecnology and Public Health, University of Cádiz, Cádiz, Spain
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Level of Stigma among Spanish Nursing Students toward Mental Illness and Associated Factors: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234870. [PMID: 31816966 PMCID: PMC6926928 DOI: 10.3390/ijerph16234870] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/29/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022]
Abstract
Mental health problems have been identified by the World Health Organization as a global development priority. Negative attitudes toward mental health patients have been documented in multiple health professionals. The aim of this study was to determine the level of stigma and associated factors toward people with mental health problems among students doing their degree in nursing. An explanatory sequential mixed-methods approach. A cross-sectional descriptive observational study was carried out on a sample of 359 students doing their degree in nursing. Students had to be enrolled in any of the four years of study of the degree at the time the questionnaire was done. We explored the perception and experience of students doing their degree in nursing regarding the level of stigma, through in-depth interviews (n = 30). The mean overall Mental Health Stigma Scale (MHSS) score was 30.7 points (SD = 4.52); 29.5% (n = 106) scored low for stigma, 49.9% (n = 179) showed moderate stigma, and 20.6% (n = 74) scored high. The multivariate analysis showed that 4th-year students had an OR of 0.41 (CI95%: 0.20–0.84) for high/moderate stigma and that 3rd-year students had an OR of 0.49 for high/moderate stigma compared with 1st-year students. We also observed that students with family members with mental health problems had an OR of 2.05 (CI95%: 1.19–3.56) for high/moderate stigma compared with students who did not have family members with mental health problems. The following categories emerged: fear and lack of knowledge, breaking the silence, and integration into society. The levels of mental health stigma in our sample of nursing students were moderate. Stigma levels were lower in 3rd- and 4th-year students (i.e., after having received training in mental health), and in students with family members with mental health problems.
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