An Investigation Into the Factor Structure of the Attitudes to Suicide Prevention Scale

Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000-2019

WHAT IS KNOWN ON THE SUBJECT?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person-oriented (for example groups of people with a similar mental health diagnosis) or practice-oriented (for example practices such as seclusion or restraint). It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory-informed approaches to attitudinal research. By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets-indicated by large proportions of respondents who appraise negatively-concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice. There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments. Training programmes that focus on attitudinal change need to be more rigorously evaluated. ABSTRACT: Introduction Attitudes are considered integral to mental health nursing practice. Aims To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK-based mental health nurses' attitudes with multi-item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude-practice links. Discussion This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co-morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude-practice links.

Measuring Attitudes toward Suicide Prevention among Occupational Staff Frequently Exposed to Suicidal Individuals: Psychometric Evaluation and Validation

As the attitudes of healthcare staff are thought to influence the quality and effectiveness of interventions targeting patients’ suicide risk, attitudes are often used as an outcome in the evaluation of suicide-preventive training. Due to various problems related to the validity and reliability of commonly used scales, there is a lack of overall agreement on how to measure these attitudes. Confirmatory factor analysis (CFA) was used to cross-validate previously used models and to investigate new models to measure professionals’ attitudes toward work with suicidal individuals and to test the longitudinal stability of the models by analyzing new sets of data. The population in the first study consisted of a heterogenous group of 1350 professionals who managed suicidal individuals relatively frequently. The second study included 640 professionals. The results of the cross-validation of previous models were described and a new questionnaire measuring attitudes toward suicide prevention, suicidal individuals, and organizational-facilitated self-efficacy (OSAQ-12) was presented. The three presented models retained a good fit and were stable over time. Valid and reliable measurement models that measure aspects of attitudes toward suicide are a prerequisite for conducting both cross-sectional and intervention studies.

The Teacher Expectations and Values for Suicide Prevention Scale

Background: Teachers play a critical role in youth suicide prevention, yet few psychometrically sound instruments exist to measure teachers' expectations and values regarding suicide prevention. Aims: This study examined the factor structure and psychometric properties of the Teacher Expectations and Values for Suicide Prevention (TEVSP) Scale. Method: The TEVSP was administered to 500 teachers in the United States. Confirmatory factor analysis was used to determine the factor structure and bivariate correlations were used to investigate convergent and discriminant validity. Mann-Whitney U tests investigated group differences in TEVSP scores between participants who had received suicide training and those who had not. Results: Results support a three-factor hierarchical model with strong internal consistency and evidence of validity. Significant differences were found in TEVSP scores between groups. Limitations: There is a need to further explore the psychometric properties of the scale across samples and face-to-face methods. Conclusion: The TEVSP is a sound instrument that can be used to measure teachers' expectations and values for suicide prevention.