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Gurusamy J, Amudhan S, Menen M, Veerabhadraiah KB, Damodharan D. Barriers and Needs of Mental Health Nursing Practitioners toward the Provision of Physical Health Care for Individuals with Severe Mental Illness: Findings from a Cross-Sectional Survey in India. Issues Ment Health Nurs 2023; 44:1009-1019. [PMID: 37819752 DOI: 10.1080/01612840.2023.2262581] [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: 10/13/2023]
Abstract
Despite the potential and opportunity for nurses in mental health settings to deliver comprehensive care to individuals with severe mental illnesses, existing evidence indicates inadequacy in providing physical health care. To understand this gap, we examined the mental health nurse's attitudes, practices, training needs, and barriers toward physical healthcare of individuals with severe mental illness and explored the associated socio-demographic differences. All mental health nurses working in an apex mental health care center in India were assessed using a self-administered questionnaire, which included a socio-demographic profile and the Physical Health Attitude Scale (PHASe). Overall, the nurses held positive attitudes, with items related to smoking and confidence toward physical health care delivery showing more positive ratings than those items related to attitude and perceived barriers. Lack of motivation from patients and nurse's workload in provision of psychiatric care were perceived as major barriers. Nurses with lesser years of experience had a slightly more positive attitude. The findings have important implications for mental health nursing practice and training toward strengthening holistic nursing care for individuals with severe mental illness, specifically in countries with limited resources.
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Affiliation(s)
- Jothimani Gurusamy
- College of Nursing, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Senthil Amudhan
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Melwine Menen
- Clinical Nursing Services, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | | | - Dinakaran Damodharan
- Center for Psychosocial Support and Disaster Management, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
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Onwubu SC, Sibiya MN, Makgobole MU. Mental Health Challenges during COVID-19 Pandemic: Experiences of Primary Healthcare Nurses in Durban, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6683. [PMID: 37681823 PMCID: PMC10488164 DOI: 10.3390/ijerph20176683] [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: 08/04/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
The COVID-19 pandemic had a significant impact on the mental health of individuals globally, and primary healthcare (PHC) nurses play a critical role in providing mental healthcare services. However, limited research has explored the experiences of PHC nurses in providing mental healthcare services during the COVID-19 pandemic. This study explored the experiences of PHC nurses in providing mental healthcare services during the pandemic in Durban, South Africa. The aim was to identify the challenges faced by healthcare providers and the potential for innovative approaches to improve access to care. A qualitative, exploratory design guided the study, and data were collected through in-depth interviews with twelve PHC nurses purposively selected. Thematic analysis was used to analyze the data. Findings from interviews with PHC nurses reveal that the pandemic exacerbated existing challenges, including medication adherence issues, fear and uncertainty among patients, vaccine hesitancy, decreased clinic visits, and the mental and emotional toll on both patients and healthcare workers. PHC nurses adapted their services by increasing outreach efforts, prioritizing patient care, and utilizing technology and non-governmental organizations' (NGOs) support. Challenges included reduced patient visits, complexities in healthcare provision, and a lack of adequate support. Positive changes observed include increased mental health awareness among healthcare professionals and younger generations. Recommendations include implementing outreach and awareness campaigns, providing accurate information about COVID-19 and vaccinations, and promoting cultural sensitivity in mental healthcare provision.
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Affiliation(s)
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Umlazi 4031, South Africa;
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Valentim O, Moutinho L, Laranjeira C, Querido A, Tomás C, Longo J, Carvalho D, Gomes J, Morgado T, Correia T. "Looking beyond Mental Health Stigma": An Online Focus Group Study among Senior Undergraduate Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4601. [PMID: 36901609 PMCID: PMC10002096 DOI: 10.3390/ijerph20054601] [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: 12/31/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Evidence highlights the need for professionals to be aware of their stigmatizing attitudes and discriminatory practices in order to minimize the negative impact on the people they take care of. However, nursing students' perceptions of these issues have been poorly studied. This study explores the perspective of senior undergraduate nursing students on mental health and the stigma around it, by considering a simulated case vignette of a person with a mental health problem. A descriptive qualitative approach was chosen and involved three online focus group discussions. The findings show various manifestations of stigma, both at an individual and collective level, which indicates that it is an obstacle to the wellbeing of people with mental illness. Individual manifestations of stigma concern its effect on the person with mental illness, while at the collective level they concern the family or society in general. Stigma is a multifactorial, multidimensional, and complex concept, in terms of identifying and fighting it. Thus, the strategies identified involve multiple approaches at the individual level, aimed at the patient and family, namely through education/training, communication, and relationship strategies. At the collective level, to intervene with the general population and specific groups, such as groups of young people, strategies suggested include education/training, use of the media, and contact with people with mental disorders as ways to fight stigma.
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Affiliation(s)
- Olga Valentim
- CINTESIS@RISE, Nursing School of Porto (ESEP), 4200-450 Porto, Portugal
- Higher School of Nursing of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Lídia Moutinho
- Higher School of Nursing of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Carlos Laranjeira
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Ana Querido
- CINTESIS@RISE, Nursing School of Porto (ESEP), 4200-450 Porto, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Catarina Tomás
- CINTESIS@RISE, Nursing School of Porto (ESEP), 4200-450 Porto, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - João Longo
- Ribeiro Sanches Higher School of Health (ERISA)–IPLUSO, 1950-396 Lisboa, Portugal
- Unidade de Investigação e Desenvolvimento em Educação e Formação (UIDEF), Instituto de Educação da Universidade de Lisboa, 1649-013 Lisboa, Portugal
- Núcleo de Investigação em Ciências e Tecnologias da Saúde (NICITeS), Instituto Politécnico da Lusofonia, 1950-369 Lisboa, Portugal
| | - Daniel Carvalho
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - João Gomes
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - Tânia Morgado
- CINTESIS@RISE, Nursing School of Porto (ESEP), 4200-450 Porto, Portugal
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Pediatric Hospital, Coimbra Hospital and University Centre, R. Dr. Afonso Romão, 3000-602 Coimbra, Portugal
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Tânia Correia
- CINTESIS@RISE, Nursing School of Porto (ESEP), 4200-450 Porto, Portugal
- Ribeiro Sanches Higher School of Health (ERISA)–IPLUSO, 1950-396 Lisboa, Portugal
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Primary health care nurses' mental health knowledge and attitudes towards patients and mental health care in a South African metropolitan municipality. BMC Nurs 2023; 22:25. [PMID: 36707801 PMCID: PMC9883930 DOI: 10.1186/s12912-023-01188-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND In South Africa, there are on-going calls to integrate mental health services into existing primary health care (PHC) programmes such as Tuberculosis (TB). Successful service integration and quality service delivery partially depend on healthcare providers' mental health-related knowledge and attitudes. The aim of this study was to assess PHC nurses' mental health knowledge and attitudes towards mental health patients and mental health care. METHODS This was a cross-sectional survey involving the distribution of self-administered questionnaires among PHC nurses across 47 clinics. Data on socio-demographics, stigma-related mental health knowledge, and nurses' attitudes towards people with mental health problems and mental health care were subjected to descriptive and multiple regression analyses. RESULTS Out of 205 respondents, the majority were female (n = 178, 86.8%). The nurses' median age was 50 (interquartile range: 39-56). Their mean mental health knowledge score was 23.0 (standard deviation [sd]: 3.07) out of 30. Nurses were less knowledgeable about the employment (n = 95, 46.3%), recovery (n = 112, 54.6%), and help-seeking behaviour (n = 119, 58.0%) of people with mental health problems. Professional nurses had a significantly higher mean mental health knowledge score than enrolled/assistant nurses (22.8 vs. 21.1, t203 = 4.775, p < 0.001). Regarding attitudes, the nurses' mean attitude score was 40.68 (sd: 9.70) out of 96. Two in every five nurses (n = 91, 44.4%) scored above the mean attitude score, implying that they were inclined to have negative (stigmatising) attitudes towards people with mental problems and mental health care. Age (p = 0.048), job category (p < 0.001), and prior in-service mental health training (p = 0.029) made a unique contribution to predicting nurses' attitudes. CONCLUSION Gaps were established in PHC nurses' stigma-related mental health knowledge. A significant proportion of nurses had a propensity for negative (stigmatising) attitudes towards mental health patients and mental health care. Efforts towards integration of mental health into TB services in this metropolitan and similar settings should address mental health knowledge deficits and factors influencing nurses' negative attitudes. In-service training on mental health should be optimised, with attention to older nurses and enrolled/nursing assistants.
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Kordom A, Daniels F, Chipps J. Training needs of professional nurses in primary health care in the Cape Metropole, South Africa. Afr J Prim Health Care Fam Med 2022. [DOI: 10.4102/phcfm.v14i1.3741] [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] Open
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Korhonen J, Axelin A, Stein DJ, Seedat S, Mwape L, Jansen R, Groen G, Grobler G, Jörns-Presentati A, Katajisto J, Lahti M. Mental health literacy among primary healthcare workers in South Africa and Zambia. Brain Behav 2022; 12:e2807. [PMID: 36326480 PMCID: PMC9759138 DOI: 10.1002/brb3.2807] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. METHODS The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. RESULTS Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. CONCLUSION The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.
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Affiliation(s)
- Joonas Korhonen
- Health and Well-being, Turku University of Applied Science, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lonia Mwape
- Levy Mwanawasa Medical University, School of Nursing and Midwifery Sciences, Lusaka, Zambia
| | - Ronelle Jansen
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Gunter Groen
- Department of Social Work, Faculty of Business and Social Sciences, University of Applied Sciences, Hamburg, Germany
| | - Gerhard Grobler
- Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
| | - Astrid Jörns-Presentati
- Department of Social Work, Faculty of Business and Social Sciences, University of Applied Sciences, Hamburg, Germany
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Mari Lahti
- Health and Well-being, Turku University of Applied Science, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
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- Health and Well-being, Turku University of Applied Science, Turku, Finland
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Rayan A. Cultural Misconceptions, Attitudes, Knowledge, and Beliefs About Mental Illness Among Jordanian Nurses Working in Psychiatric Units. J Contin Educ Nurs 2022; 53:513-520. [PMID: 36318712 DOI: 10.3928/00220124-20221006-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background This study examined cultural misconceptions and attitudes about mental illness and their correlates among Jordanian nurses working in psychiatric units. Method A descriptive, cross-sectional, correlational research design was used. A sample of 157 mental health nurses completed the study. Participants provided information about their demographics and attitudes, knowledge, and cultural misconceptions regarding mental illness. Results Negative attitudes toward mental illness were associated with sex, workplace, marital status, age, income, and years of experience. Stigma toward mental illness was associated with sex, workplace, marital status, age, years of experience, and knowledge regarding mental illness. Various cultural myths and beliefs regarding mental illness were reported. Attitudes and stigma toward mental illness differed based on cultural myths and beliefs. Conclusion Educational programs to raise awareness of and reduce stigma toward mental illness are required not only for the general public but also for some health care providers working in psychiatric units. [J Contin Educ Nurs. 2022;53(11):513-520.].
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Munsami A, Nightingale S, Sorsdahl K, Joska JA. Exploring HIV-Associated Neurocognitive Impairment in the Era of Effective Antiretroviral Therapy: A Primary Healthcare Perspective. QUALITATIVE HEALTH RESEARCH 2022; 32:1487-1497. [PMID: 35770984 PMCID: PMC9411698 DOI: 10.1177/10497323221110801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The prevalence of HIV-associated neurocognitive impairment (H-NCI) is concerning. Individuals on effective antiretroviral therapy (ART) may still be at risk for H-NCI as they experience longer life expectancies. There are, however, few professionals with knowledge and skills to identify H-NCI, in low- and middle-income countries. We explored qualitatively, primary healthcare workers' knowledge and views of H-NCI, in the era of effective ART, particularly their views toward task-sharing of H-NCI screening from specialists to mid-level or lay healthcare providers. The first phase of data collection involved two focus group discussions (FGDs) 23 primary healthcare workers from two facilities in the Western Cape participated in the FGDs. In the second phase of data collection12 individual, in-depth interviews were conducted in KwaZulu-Natal. Using thematic analysis, several key themes emerged. Although healthcare providers were unable to specifically identify H-NCI, they described several HIV disease and treatment related or mental health comorbidities that could be responsible for the symptoms. Despite healthcare workers reporting low frequencies of H-NCI, they favoured receiving training to screen for H-NCI with a view toward providing holistic care.
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Affiliation(s)
- Adele Munsami
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sam Nightingale
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Katherine Sorsdahl
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - John A. Joska
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Kigozi G. Confirmatory factor analysis of the Patient Health Questionnaire-9: A study amongst tuberculosis patients in the Free State province. S Afr J Infect Dis 2021; 35:242. [PMID: 34485486 PMCID: PMC8378120 DOI: 10.4102/sajid.v35i1.242] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/12/2020] [Indexed: 01/30/2023] Open
Abstract
Background There is growing evidence that depression is frequently comorbid with tuberculosis (TB) and is often associated with a decreased quality of life and poor treatment outcomes. The Patient Health Questionnaire (PHQ-9) is widely used to screen for depression in clinical settings in low-and middle-income countries. This study examined the construct validity and reliability of an interviewer-administered PHQ-9 in a sample of new TB patients in the Free State province of South Africa. Methods A pilot study was conducted in 2019 amongst 208 new adult TB patients attending primary healthcare facilities in the Lejweleputswa District in the Free State. Trained fieldworkers administered a structured questionnaire comprising of questions on patient’s socio-demographic characteristics and the nine-item PHQ-9 to the patients. Confirmatory factor analysis and Cronbach’s alpha were respectively used to investigate the construct validity and internal consistency of the PHQ-9. Results The model was a good fit, with a Tucker–Lewis index of 0.976, a comparative fit index of 0.982 and a root mean square error of approximation of 0.062 (90% CI: 0.032–0.089). All indicators showed significant positive factor loadings, with standardised coefficients ranging from 0.467 to 0.799. The PHQ-9 was characterised by a single factor latent structure – depression – underlying all items. The Cronbach’s alpha of the scale was 0.84. Conclusion The results support a unidimensional structure of the PHQ-9, with satisfactory internal consistency implying that the scale is valid and reliable. The TB programme can confidently consider the PHQ-9 for the routine assessment of depression amongst TB patients in the Free State province and similar settings.
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Affiliation(s)
- Gladys Kigozi
- Department Center for Health Systems Research & Development, Faculty Humanities, Free State University, Bloemfontein, South Africa
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10
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Kigozi G. Construct validity and reliability of the generalised anxiety disorder-7 scale in a sample of tuberculosis patients in the Free State Province, South Africa. S Afr J Infect Dis 2021; 36:298. [PMID: 34522696 PMCID: PMC8424773 DOI: 10.4102/sajid.v36i1.298] [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: 05/05/2021] [Accepted: 07/08/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Generalised anxiety disorder (GAD) frequently occurs amongst patients with tuberculosis (TB) and contributes to poor quality of life and treatment outcomes. This study evaluated the construct validity and reliability of the GAD-7 scale in a sample of patients with TB in the Free State Province. METHODS A pilot study was conducted amongst a convenience sample of 208 adult patients newly diagnosed with drug-susceptible TB attending primary healthcare (PHC) facilities in the Lejweleputswa District in the Free State. A structured interviewer-administered questionnaire comprising social demographic questions and the GAD-7 scale was used. Confirmatory factor analysis was used to investigate the construct validity of the GAD-7 scale. The reliability of the scale was assessed by calculating Cronbach's alpha. RESULTS The analysis showed that a modified two-factor (somatic symptoms and cognitive -emotional symptoms) model, in which the items 'Not being able to stop or control worrying' and 'Worrying too much about different things' were allowed to covary (Comparative Fit Index: 0.996, Tucker-Lewis Index: 0.993, Root Mean Square Error of Approximation: 0.070, 90% confidence interval: 0.032-0.089), fitted the data better than a unidimensional (generalised anxiety) or an unmodified two-factor model. The indicators all showed significant positive factor loadings, with standardised coefficients ranging from 0.719 to 0.873. The Cronbach's alpha of the scale was 0.86. CONCLUSION The modified two-factor structure and high internal consistency respectively provide evidence for construct validity and reliability of the GAD-7 scale for assessing GAD amongst patients with TB. Studies are necessary to assess the performance of this brief scale under routine TB programme conditions in the Free State.
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Affiliation(s)
- Gladys Kigozi
- Centre for Health Systems Research & Development, Faculty of the Humanities, University of the Free State, Bloemfontein, South Africa
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Minty Y, Moosa MY, Jeenah FY. Mental illness attitudes and knowledge in non-specialist medical doctors working in state and private sectors. S Afr J Psychiatr 2021; 27:1592. [PMID: 34192080 PMCID: PMC8182464 DOI: 10.4102/sajpsychiatry.v27i0.1592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/11/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An increasing number of South Africans utilise primary healthcare services (either in the state or private sector) for mental health concerns; hence, there is a need to objectively assess these doctors' attitudes and knowledge of mental illness. AIM To investigate aspects of knowledge and attitudes towards mental illness of a group of private and state-employed non-specialist medical doctors. METHOD Doctors in the state sector who were working at a primary healthcare level and who were not working towards, or did not hold, a specialist qualification were considered eligible for the study. Doctors in the private sector who were working as general practitioners and who did not hold a specialist qualification were considered eligible for the study. Data were collected by means of a self-administered questionnaire. A link to the study questionnaire, information about the study, details of the researcher and matters pertaining to informed consent were emailed to potential participants. RESULTS Of the 140 practitioners who responded to the survey, 51.4% (n = 72) worked in the state sector, 41.4% (n = 58) worked in the private sector and 7.1% (n = 10) worked in both the state and private sectors (χ2 1 = 45.31, p < 0.010). The majority (> 50%) of participants in all three groups had a positive attitude towards mental illness (χ2 2 = 1.52, p = 0.468). Although there were no significant associations between attitude and socio-demographic characteristics (p > 0.05), male SS doctors reported feeling less comfortable when dealing with mentally ill patients (p = 0.015); SS doctors who did not have family contact with mental illness were less likely to feel that mentally ill patients did not pose a risk to others (p = 0.007), and PS doctors under the age of 35 years were more likely to feel adequately trained to treat mental illness (p = 0.026). The majority (> 50%) of participants in all three groups had an adequate level of knowledge of mental illness (modal scores = 10). There were no significant associations between knowledge and socio-demographic characteristics (p > 0.05). CONCLUSION Despite the findings of a positive attitude and adequate knowledge of mental illness amongst the participants of this study, it is recommended that more targeted interventions are established to further improve mental health awareness and knowledge of doctors at both undergraduate and postgraduate levels of study.
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Affiliation(s)
- Yumna Minty
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mahomed Y.H. Moosa
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Fatima Y. Jeenah
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Nóbrega MDPSDS, Fernandes CSNDN, Zerbetto SR, Sampaio FMC, Carvalho JC, Chaves SCDS. Primary health care nurses: attitudes towards the person with mental disorder. ACTA ACUST UNITED AC 2021; 42:e20200088. [PMID: 33886923 DOI: 10.1590/1983-1447.2021.20200088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/04/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify the attitudes of nurses working in Primary Health Care towards the person with mental disorder and the variables related to health care provided. METHODOLOGY Descriptive, correlational study with 250 nurses from 69 Basic Health Units in the city of São Paulo. Data collection took place between April and August 2019 using the "Opinions about Mental Illness" scale. The data were analyzed using the KrusKal-Wallis test, with a 95% confidence level and statistical significance of p <0.05. RESULTS The global mean of the scale was 197, which shows negative attitudes especially in the dimensions of Authoritarianism (44.6), Social Restriction (42.0), and positive in the dimension of Benevolence (51.7). CONCLUSION Nurses tend to have a stigmatizing attitudinal profile. It is necessary formative and permanent intervention so that it is possible to reduce stigma and improve community-based care recommended in the guidelines of the Psychosocial Care Network.
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Card M, McGlynn K. Primary health care nurses’ perceptions of the socio-ecology of mental illness among patients: An exploratory study. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1842599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Melissa Card
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
| | - Kim McGlynn
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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Spagnolo J, Champagne F, Leduc N, Rivard M, Melki W, Piat M, Laporta M, Guesmi I, Bram N, Charfi F. Building capacity in mental health care in low- and middle-income countries by training primary care physicians using the mhGAP: a randomized controlled trial. Health Policy Plan 2020; 35:186-198. [PMID: 31794027 DOI: 10.1093/heapol/czz138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2019] [Indexed: 12/15/2022] Open
Abstract
To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)' training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme's impact on PCPs' mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training. We conducted an exploratory trial with a combination of designs: a pretest-posttest control group design and a one-group pretest-posttest design were used to assess the training's short-term impact; and a repeated measures design was used to assess the training's long-term impact. The former relied on a delayed-intervention strategy: participants assigned to the control group (Group 2) received the training after the intervention group (Group 1). The intervention consisted of a weekly mhGAP-based training session (totalling 6 weeks), comprising lectures, discussions, role plays and a support session offered by trainers. Data were collected at baseline, following Group 1's training, following Group 2's training and 18 months after training. Descriptive, bivariate and ANOVA analyses were conducted. Overall, 112 PCPs were randomized to either Group 1 (n = 52) or Group 2 (n = 60). The training had a statistically significant short-term impact on mental health knowledge, attitudes and self-efficacy scores but not on self-reported practice. When comparing pre-training results and results 18 months after training, these changes were maintained. PCPs reported a decrease in referral rates to specialized services 18 months after training in comparison to pre-training. The mhGAP-based training might be useful to increase mental health knowledge and self-efficacy, and decrease reported referral rates and negative mental health attitudes among PCPs in Tunisia and other low- and middle-income countries. Future studies should examine relationships among these outcome variables.
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Affiliation(s)
- Jessica Spagnolo
- School of Public Health, IRSPUM, Université de Montréal, 7101 Park Avenue, Montréal, Québec H3N 1X9, Canada
| | - François Champagne
- School of Public Health, IRSPUM, Université de Montréal, 7101 Park Avenue, Montréal, Québec H3N 1X9, Canada
| | - Nicole Leduc
- School of Public Health, IRSPUM, Université de Montréal, 7101 Park Avenue, Montréal, Québec H3N 1X9, Canada
| | - Michèle Rivard
- School of Public Health, IRSPUM, Université de Montréal, 7101 Park Avenue, Montréal, Québec H3N 1X9, Canada
| | - Wahid Melki
- Hôpital Razi, Manouba, Tunisia.,Faculté de médecine, Université de Tunis El-Manar, Tunis, Tunisia
| | - Myra Piat
- Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada.,Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montréal, QC H3A 1A1, Canada
| | - Marc Laporta
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montréal, QC H3A 1A1, Canada.,The Montréal WHO-PAHO Collaborating Centre for Research and Training in Mental Health, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Imen Guesmi
- Centre médico-scolaire et universitaire de Manouba, Manouba, Tunisia
| | - Nesrine Bram
- Hôpital Razi, Manouba, Tunisia.,Faculté de médecine, Université de Tunis El-Manar, Tunis, Tunisia
| | - Fatma Charfi
- Faculté de médecine, Université de Tunis El-Manar, Tunis, Tunisia.,Hôpital Mongi-Slim, La Marsa, Tunisia
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Atitudes de enfermeiros de cuidados primários frente à doença mental: comparação Brasil-Portugal. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao01456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Field S, Abrahams Z, Woods DL, Turner R, Onah MN, Kaura DK, Honikman S. Accessible continued professional development for maternal mental health. Afr J Prim Health Care Fam Med 2019; 11:e1-e7. [PMID: 30843415 PMCID: PMC6407441 DOI: 10.4102/phcfm.v11i1.1902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 11/19/2022] Open
Abstract
Background Changing global health and development trends have resulted in a need for continued professional development (CPD) within the health and development sectors. In low-resource settings, where the need for training and CPD may be highest, there are significant challenges for disseminating information and skills. There is a need to improve mental health literacy and reduce levels of stigma about maternal mental illness. The Bettercare series of distance learning books provides a peer-based format for CPD. We aimed to evaluate the Bettercare Maternal Mental Health book as a format for CPD. Aim The aim of this study was to determine whether the Bettercare Maternal Mental Health book significantly improves knowledge and decreases stigma around mental health for care providers from the health and social development sectors. Setting One hundred and forty-one participants (social workers, nursing students and health professionals) were provided with the Bettercare Maternal Mental Health book to study. Methods Before and after studying the book, the same multiple-choice knowledge test and the Mental Illness Clinicians’ Attitude Scale were used to assess cognitive knowledge and mental health stigma, respectively. Results Participants’ knowledge showed a statistically significant (p < 0.001) improvement between the pre- and post-test results, for all six chapters of the book. However, participants’ attitudes towards mental illness did not show a statistically significant change between the pre- and post-test results. Conclusion We found that this method of learning elicited significant improvement in mental health knowledge for care providers. Continued professional development policy planners and curriculum developers may be interested in these findings.
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Affiliation(s)
- Sally Field
- Department of Psychiatry and Mental Health, University of Cape Town.
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Fernandes CSNDN, Santos WBCD, Moreira WC, Vargas DD, Nóbrega MDPSDS. Opinions on mental illness from the perspective of primary care nurses in Portugal. Rev Gaucha Enferm 2019; 40:e20190034. [DOI: 10.1590/1983-1447.2019.20190034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/09/2019] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To identify the opinions of primary care nurses regarding mental illness and the care provided to this population. Methodology: Cross-sectional, quantitative study with the participation of 328 nurses of primary health care in Porto, Portugal. Data collected between April and August of 2018 through the scale "Opinions about Mental Illness" and socio demographic and labor questionnaire. Descriptive and correlational statistics were applied. Results: A total of 50% of the nurses presented positive opinions about the mental illness. Regarding the assistance provided in their unit of action, 53.4% considered inadequate and 50.3% recognized as adequate their knowledge about the role that primary health care has in assisting the person with mental illness. Conclusion: Positive opinions and recognition of the importance of primary care to people with mental illness are important indicators for qualified mental health care outside the field of specialty.
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Spagnolo J, Champagne F, Leduc N, Rivard M, Piat M, Laporta M, Melki W, Charfi F. Mental health knowledge, attitudes, and self-efficacy among primary care physicians working in the Greater Tunis area of Tunisia. Int J Ment Health Syst 2018; 12:63. [PMID: 30386422 PMCID: PMC6203218 DOI: 10.1186/s13033-018-0243-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-specialists' involvement in mental health care is encouraged in the field of global mental health to address the treatment gap caused by mental illness, especially in low- and middle-income countries. While primary care physicians (PCPs) are involved in mental health care in Tunisia, a lower-middle-income country in North Africa, it is unclear to what extent they are prepared and willing to address mental health problems, substance use disorders, and suicide/self-harm. In this context, we aim (1) to report on mental health knowledge, attitudes, and self-efficacy among a sample of PCPs working in the Greater Tunis area, prior to the implementation of a mental health training program developed by the World Health Organization; and (2) to identify what characteristics are associated with these competencies. METHODS In total, 112 PCPs completed questionnaires related to their socio-demographic and practice characteristics, as well as their mental health knowledge, attitudes, and self-efficacy. Descriptive analyses and regression models were performed. FINDINGS PCPs had more knowledge about depression, symptoms related to psychosis, and best practices after a suicide attempt; had favourable attitudes about distinctions between physical and mental health, learning about mental health, and the acceptance of colleagues with mental health issues; and believed most in their capabilities related to depression and anxiety. However, most PCPs had less knowledge about substance use disorders and myths about suicide attempts; had unfavorable attitudes about the dangerousness of people with mental health problems, personal disclosure of mental illness, non-specialists' role in assessing mental health problems, and personal recovery; and believed the least in their capabilities related to substance use disorders, suicide/self-harm, and psychosis. Participation in previous mental health training, weekly hours (and weekly hours dedicated to mental health), weekly provision of psychoeducation, and certain work locations were associated with better mental health competencies, whereas mental health knowledge was negatively associated with weekly referrals to specialized services. CONCLUSIONS Findings suggest that PCPs in our sample engage in mental health care, but with some gaps in competencies. Mental health training and increased interactions/involvement with people consulting for mental health issues may help further develop non-specialists' mental health competencies, and integrate mental health into primary care settings.
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Affiliation(s)
- Jessica Spagnolo
- School of Public Health, IRSPUM, University of Montreal, Montreal, QC H3N1X9 Canada
| | - François Champagne
- School of Public Health, IRSPUM, University of Montreal, Montreal, QC H3N1X9 Canada
| | - Nicole Leduc
- School of Public Health, University of Montreal, Montreal, QC Canada
| | - Michèle Rivard
- School of Public Health, University of Montreal, Montreal, QC Canada
| | - Myra Piat
- Douglas Mental Health University Institute, McGill University, Montreal, QC Canada
| | - Marc Laporta
- Montreal WHO-PAHO Collaborating Center for Research and Training in Mental Health, McGill University, Montreal, QC Canada
| | - Wahid Melki
- Razi Hospital, University of Tunis El-Manar, Tunis, Tunisia
| | - Fatma Charfi
- Mongi-Slim Hospital, University of Tunis El-Manar, Tunis, Tunisia
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