Primary health care nurses attitude towards people with severe mental disorders in Addis Ababa, Ethiopia: a cross sectional study

Medical student's attitude toward severe mental illness and its associated factors at the university of Gondar, Northwest Ethiopia

Introduction

Mental illness is mental and emotional disturbances that affect individual thinking, feeling, decision-making, mood, and daily functioning. A poor attitude toward severe mental illness means an individual has a distorted perception or attitude toward severely mentally ill patients. Despite the presence of a high burden of negative attitudes toward severe mental illness, there is a limited study conducted on Ethiopian University students. Therefore, this study aimed to reveal the prevalence of poor attitudes toward severe mental illness and its associated factors among University Gondar medical students in Northwest Ethiopia.

Method

An institutional-based cross-sectional study design was employed from Jun 25 to August 15, 2022. A structured self-administered questionnaire was used to screen the attitudes of students toward severe mental illness. Mental Illness Clinician's Attitude fourth version and Mental Health Knowledge Schedule score tools were used to screen the attitude of students. Bi-variable logistic regression analysis was employed and variables with a p-value of less than 0.25 were entered into the multivariable logistic regression for further analysis. Factors with a p-value less than 0.05 at a 95 % Confidence Interval (CI) in the multivariable logistic regression analysis were considered statistically significantly associated.

Results

From the total of 423 study participants with a 100 % response rate the overall prevalence of poor attitude towards severe mental illness among university students was 68.1 % with a 95 % CI (63.6-72.6). Age (18-24) [AOR = 2.47; 95 % CI: (1.37,4.45)], being male [AOR = 3.22; 95 % CI: (2.01-5.17)], from a rural area [AOR = 1.82; 95 % CI: (1.13-2.93)], and with no family history of mental illness [AOR = 2.07; 95 % CI: (1.12-3.82)] were statistically significantly associated factors with poor attitude towards severe mental illness.

Conclusions

and recommendations: Approximately three-fourths of university Gondar medical students (68.1 %) had poor attitudes towards severe mental illness. Age (18-24), being male, originating from a rural area, and with no family history of mental illness were significantly associated with a poor attitude toward severe mental illness. Awareness creation about mental illness can change the attitude of students which can be done by the mental health department to give as a common course can help the student to have a positive attitude.

Beliefs, Knowledge, and Perception of Indonesian Mental Healthcare Workers Regarding Mental Illness: A Cross-Sectional Study

Background

The actions of healthcare workers in treating and caring for people with mental illness are influenced by various factors. Therefore, this study aimed to assess beliefs, knowledge, and perception of Indonesian Mental Healthcare Workers (MHWs) regarding mental illness.

Materials and Methods

A cross-sectional study was conducted among 173 MHWs in May 2021 using a newly developed questionnaire distributed through convenience sampling methods.

Results

Most respondents were female (n = 135, 77.14%) and married (n = 148, 84.57%), with a mean (SD) of age of 37.57 (6.55) years old. Most believed that mental illness was caused by personal weakness (n = 131, 74.86%) and often led to mental retardation (n = 115, 65.71%). Furthermore, approximately half of this population believed mental illness could be cured through marriage (n = 80, 45.71%).

Conclusions

The evaluated MHWs commonly held misconceptions about the cause and treatments of mental illness. Consequently, relevant training was recommended to be performed for mental health literacy enhancement.

On clinical nurses' views about diversities- A qualitative study

It is a must for nurses to provide healthcare to people from diverse cultures, ethnicities, religions, and genders. This descriptive qualitative study aimed to explore nurses' approaches to various people. The study collected data via semi-structured interviews and contacted 40 nurses through snowball sampling. Most nurses were between the ages of 25-40 and female, 22 of them had postgraduate degrees, and 18 had undergraduate degrees in nursing. Only 10 of them had received special training related to diversity. MaxQda software program was used for content analyses, and four basic themes were determined respectively, "Nurses' perceptions of diversity," "Nurses' perceptions of diversity towards patients," "Nurses' perceptions of diversity towards healthcare professionals," and "Nurses' perceptions of diverse towards the institution." Participant nurses mainly revealed that although legal and organizational procedures aimed to prevent discriminative attitudes in clinical environments, discriminatory attitudes of nurses and healthcare professionals toward diverse people still occurred.

Mental illness attitudes, service provision interest and further training preferences of clinical associates

BACKGROUND

 Non-specialist health professionals are required to provide mental health services given the burden of disease due to mental illness. The study aimed to explore the attitudes of clinical associates towards those with mental illness as well as their interest in mental health work and additional mental health training.

METHODS

 A cross-sectional study design was utilised. The study population consisted of clinical associates based in South Africa. An electronic questionnaire was developed that incorporated the 16-item Mental Illness Clinicians' Attitudes version 4 scale (MICA-4), which is scored out of 96 with higher scores indicating more stigmatising attitudes. Multivariate linear regression was used to determine factors associated with the MICA-4 score.

RESULTS

 The mean MICA-4 score for the 166 participants who completed all 16 questions was 37.55 (standard deviation 7.33). In multivariate analysis, the factors associated with significantly lower MICA-4 scores were falling in the 25- to 29-year-old age category and indicating that a mental health rotation formed part of the undergraduate degree. More than 80% of the participants (140/167, 83.8%) indicated an interest in mental health work. Two-thirds of the participants (111/167, 66.5%) indicated an interest in a specialisation in mental health.

CONCLUSION

 The mean MICA-4 score recorded for clinical associates indicates low stigma levels towards those with mental illness. Additionally, there is significant interest in working and training in mental health.Contribution: Training programmes should take note of the contribution of a mental health rotation to a positive attitude to mental health patients. Clinical associates' attitudes towards mental illness together with their interest in working and training in mental health suggest that they could be more widely utilised in mental health service provision.

Perceptions of organizational value and unethical/deviant behaviors among lecturers in Archeology and Religion and Cultural Studies: An intervention study

BACKGROUND

Understanding an organization's ethical standards assists employees in abiding by stipulated rules and regulations and reduces the prevalent rate of inappropriate behaviors. Unfortunately, some workers do not know and as a result, they become dysfunctional, affecting their professional identities. Given this, scholars have called for psychoeducational strategies that coach workers to improve their perceptions. With this in mind, we investigated the impact of psychoeducational coaching on workplace ethical perceptions and deviant behaviors among lecturers in Archeology and Religion and Cultural Studies.

METHODS

A group randomized control design was adopted, and a sample of lecturers was assigned to intervention and control groups using a simple allocation sequence method. Three dependent measures were used to assess the participants' irrational beliefs, work values, and deviant behaviors before the intervention, after, and 2 months later as a follow-up test. Data collected were cued into SPSS version 28. A multivariate analysis was performed to test postulated hypotheses at .05 probability level.

RESULTS

The results showed that rational-emotive behavior occupational coaching has a significant impact on reducing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. The finding of this study justified the effectiveness of rational-emotive behavior therapy (REBT) approaches in treating irrational beliefs that occasioned work-deviant behaviors among the employees.

CONCLUSION

It is concluded in this study that rational-emotive behavior occupational coaching is beneficial and effective in decreasing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. Therefore, REBT practitioners should liaise with lecturers in Archeology and Religion and Cultural Studies to advance the practice of REBT in workplaces.

Knowledge and Attitudes Regarding Depression Among a Sample of Iraqi Non-Psychiatric Nurses: A Cross-Sectional Study

Introduction

Nurses, comprising the largest profession in healthcare, play a significant role in the identification and management of mental health disorders in hospitals.

Objectives

The study assessed the knowledge and attitudes of non-psychiatric nurses and their encounters with depressive patients throughout their careers.

Methods

This was a cross-sectional descriptive study with 400 non-psychiatric nurses from different hospitals in the Kurdistan Region of Iraq during October and November 2022. The independent Student's t-test, one-way analysis of variance, and binary logistic regression were used to assess possible factors associated with knowledge and attitude toward depression.

Results

In this study, 400 non-psychiatric nurses were examined, revealing a mean age of 31.57 ± 8.59 years. Their mean scores for knowledge and attitude toward depression were 5.41 out of a maximum of 11 (standard deviation 1.15) and 5.15 out of 18 (standard deviation 1.83), respectively. Notably, differences in mean knowledge scores were observed concerning participant marital status (P = .044), while disparities in mean attitude scores are related to participant gender (P = .010). Upon binary logistic regression analysis, none of the independent variables exhibited an association with good knowledge. Nevertheless, gender emerged as a significant factor influencing attitude toward depression (odds ratio: 0.51; 95% confidence interval: 0.30-0.86; P = .012). Subsequently, in the multivariate binary logistic regression analysis, gender sustained significance (adjusted odds ratio: 0.573; 95% confidence interval: 0.348-0.942; P = .028) as the key variable impacting attitudes toward depression among non-psychiatric nurses.

Conclusion

Based on the results of this study, nurses have insufficient awareness and management skills for depression. It has been experienced and reported that nurses lack knowledge and an attitude toward depression management. The study highlights a significant gap in nurses' skills for managing depression, urging the immediate improvement of training programs. Customizing these programs to enhance nurses' abilities in identifying and managing depression is crucial.

Knowledge and attitude toward depression among healthcare professionals working in Ilu Aba Bor zone, Oromia regional state, Ethiopia, 2021: a cross sectional study

Background

Depression is the major mental disorder that frequently co-occurs with other physical illnesses, although its detection at primary healthcare is limited. Thus, the purpose of this study is to evaluate health professionals’ knowledge and attitude toward depression and its related factors.

Objective

To assess knowledge and attitude of healthcare professionals toward people with depression at different health facilities of Ilu Aba Bor zone, Ethiopia, 2021.

Methods

A cross-sectional study was carried out involving 404 primary healthcare professionals using a systematic random sampling technique in February 2021. Attitude was assessed using depression attitude questionnaires. Epi-data version 3.1 and SPSS version 26 was used for data entry and analysis. The p -values lower than 0.05 were deemed statistically significant.

Result

In the current study, 30.4% (95% CI; 25.86, 34.94) of the respondents have inadequate knowledge and 29.9% (95% CI; 25.4, 36.8) have negative attitude toward depression. A vast majority (77.7%) of healthcare professionals have never received any kind of training on mental health. Accordingly, contact with the person with mental illness and mental health training were significantly associated with inadequate knowledge. In addition, perceived cause of depression and mental health training were significantly associated with negative attitude.

Conclusion

According to this study, the magnitude of inadequate knowledge and negative attitude in the diagnosis and treatment of depression is comparably high. Therefore, primary healthcare settings should prioritize raising awareness, promoting positive attitudes, and improving detection and treatment of depression cases.

Testing the impact of occupational intervention on professional ethics and values of Staff in University Medical Centers

BACKGROUND

The level of commitment to jobs is the driver of how much a worker could offer to those that need the services. People become poised to deliver services when they hold the job in high esteem. Evidence abounds that some workers in public services barely value their professional responsibilities and conduct. This motivated the present researchers to test the impacts of rational emotive behavioral occupational intervention (REBOI) on the professional ethics and values of Staff in University Medical Centers.

METHODS

to achieve the above aim, a randomized control design was used. A total of 114 staff were recruited, assessed 3 times using 3 instruments, and coached by therapists. The coaching last for 12 sessions. The data collected were subjected to a multivariate statistical analysis to test how effective the intervention was in changing negative perceptions about values and ethics in workplaces.

RESULTS

It was found that REBOI changes negative perceptions about professional ethics and values among staff of medical centers. The effectiveness of the REBOI is not statistically influenced by gender and group interaction. Gender does not moderate the impact of the intervention.

CONCLUSION

This study finally suggests that REBOI effectively changes negative perceptions about values and ethics among health workers. Thus, recommends for the advancement of Ellis' principles in other workplaces and across populations.

Primary health care nurses' mental health knowledge and attitudes towards patients and mental health care in a South African metropolitan municipality

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.

Cultural Misconceptions, Attitudes, Knowledge, and Beliefs About Mental Illness Among Jordanian Nurses Working in Psychiatric Units

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.].

Knowledge and attitude of health extension workers regarding mental health problems in Jimma Zone, Ethiopia: a cross-sectional study

OBJECTIVE

Health extension workers' (HEWs') knowledge and attitude regarding mental health problems are vital for integrating mental healthcare into primary healthcare services. However, information in this context is scarce in Ethiopia. So, this study aimed to assess HEWs' knowledge and attitude towards mental health problems in Jimma, Ethiopia.

DESIGN

A cross-sectional study.

SETTING

Five districts in Jimma Zone, Ethiopia, 2020.

PARTICIPANTS

A total of 259 HEWs working in selected five districts were included in the study.

OUTCOME

The knowledge and attitude status of HEWs towards mental health problems.

RESULTS

Nearly half of the respondents had inadequate knowledge (122,47.1%) and an unfavourable attitude (125, 48.3%). Most (139, 53.7%) described mental illness as due to evil spirits' possession. Almost all (240, 92.7%) of the respondents reported talking or laughing alone as a manifestation of mental illness. Almost two-thirds (157, 60.6%) of the respondents reported people with mental illness are dangerous. About a quarter (63, 24.3%) of the participants stated witch doctors should manage mental illnesses.

CONCLUSIONS

A significant proportion of the study respondents had poor knowledge and attitude towards mental health problems. Short-term and long-term mental health training is needed to improve their perception level and to provide effective community mental health services.

Relationship between social support and schizophrenia relapse among patients with schizophrenia on follow-up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: A case-control study

BACKGROUND

Severe mental illnesses affect about 4% of the adult population worldwide. The illness is highly related to the relapse rate and can cause cognitive, social, and functional deterioration in patients. While there are some factors that are known to be protective of the occurrence of relapse in schizophrenia, having good social support is found to be one of the strongest factors. Therefore, the aim of this study was to identify the association between relapse and poor social support in patients with schizophrenia.

METHODS

With unmatched case-control (case-patients with schizophrenia with poor social support and controls-patients with schizophrenia with good social support), the study included 408 patients with schizophrenia on a follow-up at Amanuel Mental Specialized Hospital from March to May; 2020. The convenience sampling technique was used to draw the participants. Social support was assessed by the Oslo social support scale (Oslo-3), whereas Family Emotional Involvement and Criticism Scale and Medication Adherence Rating Scale-10 (MARS-10) were used to assess the emotion expressed and adherence to medication, respectively. Epidemiological Information (Epi Info) version 7 was used for data coding and entry, which were then exported to the Statistical Package for Social Sciences version 22 for analysis. Unconditioned binary logistic regression analysis and bivariate correlation analysis were carried out.

RESULTS

Out of 408 samples, 396 participants, of which 194 were cases and 202 were controls, were included in the study with a response rate of 97.06%. The mean and standard deviation (SD) age of the participants was 36.06 ± 9.842 years. From 194 cases, 61.1% of them were reported to have poor social support. In multiple logistic regression, only social support was found to be statistically significant [p < 0.001, adjusted odds ratio (AOR) = 3.102, confidence interval (CI) (95%) = (1.985-4.848)]. Hence, the odds of having relapse were 3.102 higher in those who have poor social support when compared to those with good social support. Emotional involvement, financial problems, and stressful life events were found to indirectly affect relapse by having a negative correlation with social support.

CONCLUSION

The present study showed that there was a relationship between relapse and social support, and this indicates that social support can be a good predictor of schizophrenia relapse. The caregivers and clinicians of the patients should increase their support to the patients, while hospitals with mental health services have to encourage formation of better social support for the patients, including psychosocial interventions which will be performed to enhance the social support system.

Multidisciplinary team members' perceptions regarding advanced psychiatric nurses' attitudes on mental healthcare

Background

The attitudes of advanced psychiatric nurses significantly contribute to the management, treatment plan and care of the mental healthcare users, and resultantly affects the quality and standards of mental healthcare. Considering these effects, it is imperative to understand how the attitudes of advanced psychiatric nurses are perceived by other multidisciplinary team members.

Aim

To describe the perceptions of the multidisciplinary team members regarding advanced psychiatric nurses’ attitudes in clinical practice.

Setting

Three mental health institutions were utilised to obtain the perceptions related to the attitudes displayed by advanced psychiatric nurses in the clinical environment.

Method

A qualitative research descriptive approach was adopted to obtain in-depth descriptions of the attitudes portrayed by advanced psychiatric nurses. Eight purposefully sampled multidisciplinary team members were interviewed to obtain information. Data were analysed using Colaizzi’s method.

Results

Themes and sub-themes emerged. Mental healthcare providers exhibited both negative and positive attitudes towards mental health patients. By perception, unfavorable attitudes hindered effective communication and psychosocial rehabilitation programs for mental health patients. Positivity enhanced feedback during ward rounds and during clinical meetings.

Conclusion

Despite the positive impact advanced psychiatric nurses have on mental health care, views regarding mental health patients remain negative. It is recommended that advanced psychiatric nursing education curriculum address negative attitudes, views, and stereotypes. Mental healthcare users need to be provided with psychosocial rehabilitation programs and activities that address advance psychiatric nurses’ lack of initiatives.

Contribution

A clear set of principles and protocols underpins the collaborative effort among multidisciplinary teams in mental health care.

Evidence-Based Practice and Associated Factors Among Health Care Providers Working in Public Hospitals in Northwest Ethiopia During 2017

BACKGROUND

Despite the fact that evidence-based practice (EBP) is believed to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia is not evidence-based. Understanding the extent of and barriers to EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia.

OBJECTIVE

This study aimed to assess reported level of EBP and associated factors among health care providers working in public hospitals in northwest Ethiopia.

METHODS

A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire that was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP Implementation Scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation.

RESULTS

The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β = -0.10; P < 0.05); having been trained as a bachelor's degree-level nurse (β = 3.45; P < 0.001) or a bachelor's degree-level midwife (β = 2.96; P < 0.001), a general practitioner (β = 7.86; P < 0.001), or a specialist physician (β = 15.04; P < 0.001) rather than a diploma-level nurse; working in a pediatrics ward (β = -1.74; P < 0.05); and reporting as barriers either a lack of clarity on the importance of EBP (β = -0.93; P < 0.05) or a lack of orientation sessions on new health priorities (β = -0.91; P < 0.05).

CONCLUSIONS

Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia. (Curr Ther Res Clin Exp. 2020; 81:XXX-XXX).

Stigma on mental illness in the Arab world: beyond the socio-cultural barriers

Purpose

Research on mental illness stigma in the Arab world has traditionally focused on socio-cultural barriers that deprive persons with mental illness from their fundamental human right for privacy and informed consent. The purpose of this paper is to address the question whether or not mental health legislations in a number of Arab countries effectively safeguard the human rights of people with mental illness and protect them from stigmatizing and discriminatory practices.

Design/methodology/approach

A qualitative review of literature was performed over two rounds of search, targeting published research on mental illness stigma in the Arab world from year 2000 until now and existing national mental health legislations in the Arab world, using English and Arabic databases.

Findings

The review reveals that beyond society and culture, persistence of mental illness stigma in the Arab world may be explained by absent or inefficient monitoring mechanisms of mental health legislations and policies within the health-care setting. Although integration of mental health services into the primary health care system is being gradually implemented as a step toward de-stigmatization of mental illness, more remains to be done to change the stigmatizing behavior of the health personnel toward mental illness.

Originality/value

Mental health authorities in the Arab world need to be more aware of the public perceptions explaining people’s fear and reluctance to seek mental health care, so as to ensure that the control and monitoring mechanisms at both the primary and mental health care levels foster a human rights, culturally competent, patient-friendly and non-stigmatizing model of mental health care.