Violence Against Women with Mental Illness and Social Norms and Beliefs: Nursing Professional Perspective

Violence against women is a priority public health issue globally and women with mental illness are at double disadvantage. While social norms and beliefs play a critical role in influencing violence among women, limited or no research is available from India. To explore nurses and nursing students' views on social norms and beliefs that support Violence against women with mental illness. A descriptive cross-sectional survey was carried out among randomly selected registered nurses and nursing students (N = 209) using self-reported questionnaires. Majority of the participants confronted norms (76.7%) and situations that justify (67.7%) abuse among women with mental illness. Nurses reported more negative attitudes than nursing students with regard to norms and beliefs (t = - 2.714, p < 0.007) and justifiability of abuse (t = - 3.089, p < 0.002). The findings suggest suitable academic programs to extinguish the prevailing cultural beliefs that support abuse in women with mental illness.

Knowledge and perceptions of Indian primary care nurses towards mental illness

OBJECTIVES

To assess nurses' knowledge and perceptions towards mental illness.

METHODS

This was a cross-sectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness.

RESULTS

The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness' (88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing).

CONCLUSIONS

The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop and implement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Attitudes, knowledge, and willingness to donate organs among Indian nursing students

Globally, there is an acute shortage of organs for transplantation. Health professionals play an important role in raising awareness, motivating, and subsequently increasing the organ donation rates. Research related to nursing students' attitudes toward organ donation is limited from India. We aimed to assess undergraduate nursing students' knowledge, attitudes, and willingness to donate organs. This was a cross-sectional descriptive study carried out among conveniently selected undergraduate nursing students (n = 271) using self-reported questionnaires. All the participants were aware of organ donation. A majority (n = 251, 94%) of them were unaware of organ donation law. The mean score indicates that 66.7% of the participants had adequate level of knowledge [mean ± standard deviation (SD), 7.34 ± 1.61] and 72.3% hold positive attitudes (mean ± SD, 83.9 ± 1.01) toward organ donation. Statistically significant correlation (r = 0.265, P <0.001) was observed between knowledge and attitudes of the participants toward organ donation. The findings suggest the need for revising the nursing curricula to prepare the future nurses' competent in encountering the issues related to organ donation and fostering.

Prevalence and clinical correlates of obsessive-compulsive disorder in schizophrenia

Obsessive compulsive symptoms frequently occur in a substantial proportion of patients with schizophrenia. The term schizoobsessive has been proposed to delineate this subgroup of schizophrenia patients who present with obsessive-compulsive symptoms/disorder. However, whether this co-occurrence is more than just co-morbidity and represents a distinct subgroup remains controversial. A striking variation is noted across studies examining prevalence of obsessive-compulsive symptoms/disorder in schizophrenia patients and their impact on clinical profile of schizophrenia. Hence, in this study, we examined the prevalence of obsessive-compulsive symptoms/disorder in a large sample of consecutively hospitalized schizophrenia patients and compared the clinical and functional characteristics of schizophrenia patients with and without obsessive-compulsive symptoms/disorder. We evaluated 200 consecutive subjects with the DSM-IV diagnosis of schizophrenia using the Structured Clinical Interview for DSM-IV Axis I disorders, Positive and Negative Syndrome Scale, Yale-Brown Obsessive-Compulsive Scale, Brown Assessment of Beliefs Scale, Clinical Global Impression-Severity scale, Global Assessment of Functioning Scale, Family Interview for Genetic Studies and World Health Organization Quality of Life scale. The prevalence of obsessive-compulsive symptoms in patients with schizophrenia was 24% (n=48); 37 of them had obsessive-compulsive disorder (OCD) and 11 had obsessive-compulsive symptoms not amounting to a clinical diagnosis of OCD (OCS). Schizophrenia patients with OCS/OCD had an earlier age at onset of schizophrenia symptoms, lower positive symptoms score, higher co-morbidity with Axis II disorders, higher occurrence of OCD in family and better quality of life. Findings of the study indicate a higher prevalence of OCS/OCD in schizophrenia. Schizophrenia patients with and without OCS/OCD have comparable clinical profile with few exceptions. High rates of OCD in first degree relatives suggest possible genetic contributions and differences in neurobiology. Finally, evidence to consider schizoobsessive as a distinct diagnostic entity is inconclusive and warrants further studies.

Undergraduate Nursing Students' Attitudes towards Mental Illness: Implications for Specific Academic Education

BACKGROUND

Health care professions are not immune to social prejudices and surprisingly share the general public's attitude attributed to people with mental illness. Nursing students are future health manpower research related to nursing students attitudes toward mental illness is limited.

AIM

The aim of this following study is to examine the undergraduate nursing students' attitudes toward people with mental illness.

MATERIALS AND METHODS

Cross-sectional descriptive design was adopted for the present study. A total of 148 undergraduate nursing students were purposively selected to complete self-reported questionnaires.

RESULTS

THE NURSING STUDENTS HAVE SIGNIFICANT POSITIVE ATTITUDES TOWARDS MENTAL ILLNESS IN THREE OF THE SIX ATTITUDES FACTORS: Restrictiveness (8.59), benevolence (29.8) and stigmatization (9.18). However, these students have negative attitudes in separatism (27.1), stereotype (11.5) and pessimistic predictions (11.7) domains as they rated high.

CONCLUSION

Academic education in this area must be planned so as to favor the change of the attitudes that include greater use of teaching strategies that challenge beliefs and assumptions and promote a commitment to provide holistic care to people with mental illness.

[Human rights violations among people with mental illness; rural vs. urban comparison]

BACKGROUND

Human rights violations are commonly reported against people with mental illness and have remained a major research issue in recent times.

OBJECTIVE

The present study was aimed to compare psychiatric patients' perceptions of human rights needs between rural and urban settings.

METHODOLOGY

A descriptive study design was carried out among 100 recovered psychiatric patients based on the Clinical Global Impression-Improvement Scale (CGI-I scale), at a tertiary care center. Participants were selected through a random sampling method. Data was collected through face to face interviews, using a structured questionnaire. Data was analyzed and interpreted using descriptive and inferential statistics.

FINDINGS

The present study highlighted the significant differences in meeting their basic human rights needs in a physical needs dimension i.e. availability of hot water for bathing (c2=8.305, p<0.40) and provision of clean clothes to wear (c2=8.229, p<0.42) were rated higher in rural participants than participants from those in an urban setting. Similarly, in the ethical needs dimension, merely 13% of the rural participants reported that they never/rarely experienced sexual advances by family members (c2=9.949, p> .019).

CONCLUSION

Our findings revealed that human rights violations among mentally ill are evident across rural and urban environments. Thus, there is an urgent need to change the attitude of the general population towards people with mental illness through awareness campaign. In addition, educating the public about the human rights of mentally ill is also essential.

An 11- to 13-year follow-up of 75 subjects with obsessive-compulsive disorder

OBJECTIVE

There is a paucity of data on the long-term course and outcome of obsessive-compulsive disorder (OCD). Available data suggest that OCD runs a chronic course with waxing and waning severity. However, most previous studies included severely ill patients who were often clinically referred and hospitalized. The present study reports the course and outcome of OCD in patients who were largely outpatient, self-referred, and drug-naive.

METHOD

Seventy-five of the 105 subjects (71%) with DSM-IV-diagnosed OCD were followed up 11 to 13 years after initial consultation in 1991 and 1992 at a major psychiatric hospital in India. A majority were self-referred (N = 63, 84%), drug-naive (N = 54, 72%), and outpatients (N = 60, 80%). The follow-up evaluations were carried out by experienced clinicians using various scales and structured instruments. The course and outcome were determined according to predefined criteria. Multinomial logistic regression analysis was performed to identify potential predictors of outcome.

RESULTS

A majority of subjects were adequately treated with medications (N = 57, 76%). Out of 75 subjects, only 18 subjects (24%) had clinical OCD. Overall, 57 subjects (76%) had a favorable outcome: 32 subjects (43%) had no OCD and 25 (33%) had subclinical OCD. Mixed OCD and any Axis I lifetime comorbidity predicted "clinical OCD" outcome.

CONCLUSIONS

Outcome of OCD is better than generally assumed, and the findings of this study offer a new perspective on the long-term outcome of OCD. Poor outcome in previous studies may have been due to the inclusion of severely and chronically ill patients.