Attitudes of qualified vs student mental health nurses towards an individual diagnosed with schizophrenia Rory Kavanagh

Background Prejudice towards schizophrenia can lead to stigmatisation Prejudice towards schizophrenia can lead to stigmatisation Labelling theory > ‘outside norms of society’ Labelling theory > ‘outside norms of society’ Increase in research field of attitudes towards mental illness Increase in research field of attitudes towards mental illness Research showed factors such as age, profession, setting, education extent an influence on attitude formation Research showed factors such as age, profession, setting, education extent an influence on attitude formation Mental health nurses play important part in efforts to reduce stigma/discrimination as they have frequent contact with service users Mental health nurses play important part in efforts to reduce stigma/discrimination as they have frequent contact with service users This research sought to explore how certain factors impacted on attitude variation within mental health nursing This research sought to explore how certain factors impacted on attitude variation within mental health nursing

Aims of Study Four hypotheses were proposed Four hypotheses were proposed 1: Statistically significant difference in attitudes and desire for social interaction between the two groups 1: Statistically significant difference in attitudes and desire for social interaction between the two groups 2: Statistically significant difference in attitudes and desire for social interaction between mental health nurses who worked in community and in patient setting 2: Statistically significant difference in attitudes and desire for social interaction between mental health nurses who worked in community and in patient setting 3: Statistically significant difference in attitudes and desire for social interaction based on years of experience 3: Statistically significant difference in attitudes and desire for social interaction based on years of experience 4: Statistically significant difference in attitudes and desire for social interaction between college years of student mental health nurses 4: Statistically significant difference in attitudes and desire for social interaction between college years of student mental health nurses

Study Design and Participants Study employed independent group design to test for differences between the groups Study employed independent group design to test for differences between the groups Independent variables were qualification (2 levels), setting (2 levels), experience (8 levels), education (4 levels) Independent variables were qualification (2 levels), setting (2 levels), experience (8 levels), education (4 levels) Dependent variables were ‘attitudes’ measured using CAMI scale and desire for social interaction measured by social interaction scale. Dependent variables were ‘attitudes’ measured using CAMI scale and desire for social interaction measured by social interaction scale. 66/95 student mental health nurses took part (63%), 54 (female) and 12 (male), age range (mean 26.1 years) 66/95 student mental health nurses took part (63%), 54 (female) and 12 (male), age range (mean 26.1 years) 121/177 mental health nurses took part (68%), 66 (female) and 55 (males), age range (mean 41 years), experience 5-39 years (mean years), 67 employed in inpatient setting and 42 in community. 121/177 mental health nurses took part (68%), 66 (female) and 55 (males), age range (mean 41 years), experience 5-39 years (mean years), 67 employed in inpatient setting and 42 in community.

Measures, ethical approval and data analysis CAMI scale, 40 self report questionnaire, possessed 4 subscales authoritarianism, benevolence, social restrictiveness and community mental health ideology, each subscale has good or adequate internal consistency. CAMI scale, 40 self report questionnaire, possessed 4 subscales authoritarianism, benevolence, social restrictiveness and community mental health ideology, each subscale has good or adequate internal consistency. SIS, 7 self report questionnaire indicating the strength of desire to be associated with the mentally ill. SIS has shown to possess excellent internal consistency. SIS, 7 self report questionnaire indicating the strength of desire to be associated with the mentally ill. SIS has shown to possess excellent internal consistency. Prior to data collection all aspects of the study were reviewed and approved by LGH’s ethics committee. Prior to data collection all aspects of the study were reviewed and approved by LGH’s ethics committee. Descriptive and inferential statistics were conducted using SPSS version 17.0 for windows, findings were statistically significant at the P < 0.05 level. Descriptive and inferential statistics were conducted using SPSS version 17.0 for windows, findings were statistically significant at the P < 0.05 level.

Results Hypothesis 1 was rejected. Hypothesis 1 was rejected. Hypothesis 2, statistically significant difference inpatient vs community setting on social restrictiveness (P = 0.037) and community mental health ideology (P = 0.025) scales of CAMI and on SIS (P = 0.020). Hypothesis 2, statistically significant difference inpatient vs community setting on social restrictiveness (P = 0.037) and community mental health ideology (P = 0.025) scales of CAMI and on SIS (P = 0.020). Hypothesis 3, statistically significant difference years based on experience, (P = 0.018), Turkey’s post hoc to determine where difference lay 5-9 years and years. Hypothesis 3, statistically significant difference years based on experience, (P = 0.018), Turkey’s post hoc to determine where difference lay 5-9 years and years. Hypothesis 4 was rejected. Hypothesis 4 was rejected.

Study Limitation Possibility of socially desirable responding Possibility of socially desirable responding Limited to one county out of 26, nation wide survey would help generalise findings Limited to one county out of 26, nation wide survey would help generalise findings Would have been desirable to further explore impact of experience by dividing inpatient and community groups, however, due to use of convenience sampling insufficient numbers of perform this analysis Would have been desirable to further explore impact of experience by dividing inpatient and community groups, however, due to use of convenience sampling insufficient numbers of perform this analysis Convenience sampling has implications for generalisation of findings, nationwide sample to support/dispute findings in rigorous fashion. Convenience sampling has implications for generalisation of findings, nationwide sample to support/dispute findings in rigorous fashion.

Study Outcomes and Implications for Practice Work setting did affect attitudes namely on community mental health ideology, social restrictiveness and desire for social interaction Work setting did affect attitudes namely on community mental health ideology, social restrictiveness and desire for social interaction Years of experience suggested that mental health nurses with less experience desire less social interaction with individuals with schizophrenia than more experienced nurses Years of experience suggested that mental health nurses with less experience desire less social interaction with individuals with schizophrenia than more experienced nurses Educational interventions should be developed highlighting impact of negative attitudes towards individuals with schizophrenia on nursing care for newly qualified nurses Educational interventions should be developed highlighting impact of negative attitudes towards individuals with schizophrenia on nursing care for newly qualified nurses Mental health nurses employed in inpatient setting should be careful that their experiences of caring for individuals in crisis does not adversely influence their behaviour Mental health nurses employed in inpatient setting should be careful that their experiences of caring for individuals in crisis does not adversely influence their behaviour

Conclusions Less experienced and those employed in an inpatient setting expressed more negative attitudes and desired less social interaction, when compared with mental health nurses with greater experience and those employed in a community setting Less experienced and those employed in an inpatient setting expressed more negative attitudes and desired less social interaction, when compared with mental health nurses with greater experience and those employed in a community setting Clash between work role and private lives in regard to desire for social interaction Clash between work role and private lives in regard to desire for social interaction Likely that negative attitudes held towards individuals with schizophrenia will interfere with therapeutic nurse/patient relationship, if true especially of less experienced nurses educational interventions with this group to highlight this issue (prejudice, discrimination and implications for nursing care) Likely that negative attitudes held towards individuals with schizophrenia will interfere with therapeutic nurse/patient relationship, if true especially of less experienced nurses educational interventions with this group to highlight this issue (prejudice, discrimination and implications for nursing care) Campaigns have been targeted at reducing stigma from media and general public, to my knowledge none yet exists for members of nursing profession. Campaigns have been targeted at reducing stigma from media and general public, to my knowledge none yet exists for members of nursing profession.