Mental health nursing and physical health care: A cross‐sectional study of nurses' attitudes,practice, and perceived training needs for the physical health care of people with severe mental illness

Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however, there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical health care and explore associations with their practice and training. A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n = 585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice regarding cancer screening and smoking cessation. Having received post‐registration physical health‐care training and working in inpatient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post‐registration physical health training or had an additional adult/general nursing qualification. Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognized. However, there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.     

The chasm of care: Where does the mental health nursing responsibility lie for the physical health care of people with severe mental illness?

The poor physical health of people with a severe mental illness is well documented and health professionals' attitudes, knowledge and skills are identified factors that impact on clients' access to care for their physical health needs. An evaluation was conducted to determine: (i) mental health nurses' attitudes and beliefs about providing physical health care; and, (ii) the effect that participant demographics may have on attitudes to providing physical health care. It was hypothesized that workplace culture would have the largest effect on attitudes. Nurses at three health services completed the “Mental health nurses' attitude towards the physical health care of people with severe and enduring mental illness survey” developed by Robson and Haddad (2012). The 28‐item survey measured: nurses' attitudes, confidence, identified barriers to providing care and attitudes towards clients smoking cigarettes. The findings demonstrated that workplace culture did influence the level of physical health care provided to clients. However, at the individual level, nurses remain divided and uncertain where their responsibilities lie. Nursing leadership can have a significant impact on improving clients' physical health outcomes. Education is required to raise awareness of the need to reduce cigarette smoking in this client population.     

Attitudes towards people with mental illness: a cross-sectional study among nursing staff in psychiatric and somatic care

Stigma and discrimination have been identified as important obstacles to the integration of people with mental illness in society. In efforts to reduce stigma and discrimination, health professionals play an important role as they have frequent contact with and responsibility for treatment and rehabilitation of consumers. The aim of the present study was to investigate attitudes towards mental illness and people with mental illness among nursing staff working in psychiatric or somatic care. The sample consisted of 120 registered or assistant nurses who were interviewed about intimacy with mental illness and attitudes about seven different mental illnesses. The results showed that nursing staff in somatic care, to a higher degree than nursing staff in mental health, reported more negative attitudes with regard to people with schizophrenia as being more dangerous and unpredictable. In contrast, professional experience, intimacy with mental illness and type of care organization were found to be more associated with attitudes to specific mental illnesses concerning the prospect of improvement with treatment and the prospect of recovery. In conclusion, attitudes among nursing staff are in several respects comparable with public opinions about mental illness and mentally ill persons. In order to elucidate if negative attitudes about dangerousness and unpredictability of persons with specific mental illnesses are associated with realistic experiences or with prejudices further studies with a qualitative design are suggested.     

Differences in job stress experienced by female and male Japanese psychiatric nurses

In psychiatric nursing, female nurses tend to spend more time building rapport with patients and developing cooperative working relationships with colleagues; they encounter more sexual harassment by patients. In contrast, male nurses respond to aggressive patients and tend to resist physically caring for female patients; they encounter more physical and verbal assault from patients. These gender differences might result in differences in job‐related stress. We quantitatively examined gender differences in psychiatric nurses' job stress. The Psychiatric Nurse Job Stressor Scale and the Stress Reaction Scale of the Brief Job Stress Questionnaire were administered to 159 female and 85 male Japanese psychiatric nurses. The results indicated that female nurses had significantly higher stress levels than males related to psychiatric nursing ability, attitude towards nursing, and stress reactions of fatigue and anxiety. Moreover, the factors affecting stress reactions differed somewhat between sexes. In particular, male nurses reported that greater irritability was affected by patients' attitudes. Their anxiety and somatic symptoms were affected by their attitude towards nursing, and depressed mood was affected by psychiatric nursing ability. Knowledge of these differences can lead to better mental health‐care interventions for psychiatric nurses.     

Mental health nurses' attitudes towards severe perinatal mental illness

Title.  Mental health nurses' attitudes towards severe perinatal mental illness.
Aim.  This paper reports on a study exploring the experiences and attitudes of generic mental health nurses towards care of women with severe mental illness during the perinatal period.
Background.  Severe mental disorder in the perinatal period is a global public health concern. However, there are concerns that mental health nurses other than dedicated perinatal mental health teams may lack knowledge, skills and experience in caring for such disorders, because of their low prevalence.
Methods.  Sixteen generic Registered Mental Nurses working in public adult mental health services participated in three focus groups during 2007.
Findings.  Participants did not perceive any difference between symptoms during perinatal and non-perinatal periods. There were mixed attitudes towards caring for women with severe mental illness in the perinatal period. Fear and anxiety was expressed by the nurses when caring or feeling responsible for the babies of clients. Lack of communication between professional groups and decreased clinical decision-making following the introduction of the Edinburgh Post Natal Depression Scale caused frustration. Confidence was displayed when working with known and trusted colleagues.
Conclusion.  Generic mental health nurses would benefit from more education on perinatal mental health and there may be a need for them to be supported by specialist perinatal mental health practitioners.     

Knowledge,attitude and behaviours toward people with mental illness among Tunisian nursing students and nonhealth care students: A cross-sectional study

BackgroundAlthough being in the frontline of healthcare and having a crucial role in the reduction of stigma, evidence has shown that nurses and undergraduate nursing students hold unfavourable attitudes toward mental illness. There is, to our knowledge, no previous study that explored attitudes toward mental illness among nursing students in Tunisia, nor in North African countries.AimWe aimed to assess stigma in nursing students as compared to nonhealth care students, and the relationship between stigma and education variables in the nursing students group.MethodsThe 'Community Attitudes toward the Mentally Ill', the 'Mental Health Knowledge Schedule', and 'Reported and Intended Behaviour Scale' were administered to 255 nursing students and 332 nonhealth care students.FindingsDespite nursing students being more knowledgeable about mental disorders than nonhealth care students; they held significantly more stigmatising attitudes toward people with mental disorders in two dimensions: Authoritarianism and Community mental health ideology. After controlling for confounders, we found that having taken mental health courses significantly predicted more favourable attitudes toward people with mental disorders and better knowledge of mental health stigma. Being interested in working in psychiatric wards helped predict more favourable attitudes and intended behaviours.DiscussionIn general, results from this study are of concern as it presents evidence of an overall similar or even greater tendency to negative attitudes toward mental illness among nursing students than among nonhealth care students.ConclusionThere is an urgent need for antistigma interventions in nursing schools. These interventions should target nursing students with the most negative attitudes, including male students and those who have never had personal experience with mental illness. Interventions should also work to build up nursing students’ interest in mental health nursing during their undergraduate years.     

The attitudes of mental health professionals towards patients with mental illness in an inpatient setting in Palestine

Culture plays a vital role in shaping public and professional attitudes towards mental illness. In Arab cultures negative attitudes toward patients experiencing mental illnesses are common. There is a lack of studies that investigate the attitudes of professionals towards patients in inpatient mental health settings. This study aimed to assess the attitudes of professionals towards patients with mental illnesses in the only psychiatric hospital in Palestine. A survey was undertaken using the Attitudes Toward Acute Mental Health Scale (ATAMHS 33). The scale was distributed to a variety of professionals at the only psychiatric hospital in Bethlehem. Data was managed and analysed by using SPSS 15 (a statistical package for social sciences). The participants (mostly nurses) expressed both negative and positive attitudes toward patients, however, results revealed more negative than positive attitudes, particularly in relation to alcohol misuse, medication, patients' ability to control their emotions, and genetic predisposition to mental illness. This paper provides baseline data about the attitude of mental health professionals towards patients experiencing mental illnesses. Education and direct contact with patients with mental illness may not be enough to foster positive attitudes towards them. This may indicate the need to revise educational curriculum at the Palestinian universities and offer more training for mental health professionals in order to change their attitudes.     

The impact of volunteering in mental health settings on nursing students' attitudes

Nursing faculties are working to improve students’ attitudes towards mental illness and people with severe mental illness, given the repercussions a lack of knowledge and negative attitudes may have on the quality of care. Complementing undergraduate programmes with volunteering activities affords students the opportunity to interact with people with a severe mental illness, and allow them to develop positive attitudes and overcome prejudice. Aim: to explore and deepen in nursing students attitudes prior to and following volunteering on an Acute Mental Health Inpatient Unit. By means of mixed methods approach, students were assessed at two time points by questionnaires including “Community Attitudes to Mental Illness” and “Semantic Differential”, and by testimonies gathered from interviews. Positives changes in attitudes were identified and monitored over time capturing a destigmatizing tendency. The participation in educational strategies such as volunteering in Acute Mental Health Inpatient Unit, complementary to undergraduate programmes and clinical placements in mental health, allows nursing students to develop more diversified and positive attitudes towards mental illness and people with severe mental illness. The impact of an interventional education strategy is not as powerful in nursing students as it might be in students of other non-healthcare oriented university degrees due to their baseline attitudes.     

Oxymoronic or synergistic: Deconstructing the psychiatric and/or mental health nurse

Examination of the names used to signify a nurse who specializes in working with people with mental health problems indicates the absence of a shared nomenclature and the frequent conflation of the terms ‘psychiatric’ and ‘mental health’. Informed by the work of Derrida (1978) and Saussure (1916–1983), the authors encourage the deconstruction of and problematization of these terms, and this shows that what nurses who work with people with so‐called mental illness are called has depended on where they have worked, the vagaries of passing fashion, and public policy. Further, there are irreconcilable philosophical, theoretical, and clinical positions that prevent nurses from practicing simultaneously as ‘psychiatric’ and ‘mental health’ nurses. Related service user literature indicates that it is disingenuous to camouflage ‘psychiatric’ services as ‘mental health’ services, and as signifiers, signified, and signs, psychiatric and mental health nursing are sustained by political agendas, which do not necessarily prioritize the needs of the person with the illness. Clearly demarked and less disingenuous signs for both mental health and psychiatric care would not only be a more honest approach, but would also be in keeping with the service user literature that highlights the expectation that there are two signs (and thus two services): psychiatric and mental health services.