Undergraduate nursing and midwifery student's attitudes to mental illness

A systematic review of midwives' training needs in perinatal mental health and related interventions

Background

Midwives may be key stakeholders to improve perinatal mental healthcare (PMHC). Three systematic reviews considered midwives' educational needs in perinatal mental health (PMH) or related interventions with a focus on depression or anxiety. This systematic review aims to review: 1) midwives' educational/training needs in PMH; 2) the training programs in PMH and their effectiveness in improving PMHC.

Methods

We searched six electronic databases using a search strategy designed by a biomedical information specialist. Inclusion criteria were: (1) focus on midwives; (2) reporting on training needs in PMH, perinatal mental health problems or related conditions or training programs; (3) using quantitative, qualitative or mixed-methods design. We used the Mixed Methods Appraisal Tool for study quality.

Results

Of 4969 articles screened, 66 papers met eligibility criteria (47 on knowledge, skills or attitudes and 19 on training programs). Study quality was low to moderate in most studies. We found that midwives' understanding of their role in PMHC (e.g. finding meaning in opening discussions about PMH; perception that screening, referral and support is part of their routine clinical duties) is determinant. Training programs had positive effects on proximal outcomes (e.g. knowledge) and contrasted effects on distal outcomes (e.g. number of referrals).

Conclusions

This review generated novel insights to inform initial and continuous education curriculums on PMH (e.g. focus on midwives' understanding on their role in PMHC or content on person-centered care).

Registration details

The protocol is registered on PROSPERO (CRD42021285926).

'We only come from one perspective': Exploring experiences of allies supporting expert by experience leadership in mental health education

INTRODUCTION

Academics from health professional backgrounds have a crucial role in supporting the implementation and sustainability of academic positions for experts by experience in mental health education. Perspectives and experiences of these academics have yet to be extensively explored. A deeper understanding will add to our understanding of this important role and provide guidance for academics with similar aspirations.

AIM

The aim of the study was to explore the experiences of supporting academic positions for experts by experience in mental health education.

METHODS

A qualitative exploratory design was utilised. In-depth interviews were conducted with academics who have actively supported academic positions for experts by experience.

RESULTS

Allyship was a key theme identified. Participants described allyship as complex, time-consuming and rewarding, through three sub-themes: the tension of allyship, the impact of being an ally and interpersonal and relational issues with health professional academics.

CONCLUSIONS

Allyship was influenced by the negative attitudes of many health professional academics, who do not appreciate the value of this work.

IMPLICATIONS FOR PRACTICE

Allyship has a crucial role in enhancing experts by experience leadership in the education of health professionals. Understanding the experience of allyship will assist in further understanding and developing these important roles.

"It Is OK Not to Be OK": Nursing Students' Backgrounds and Perceptions of Mental Health Stigma and Implications for Mental Health Nursing Education

There has been a notable increase in reported mental illnesses in recent years. Although mental illness is being discussed more openly, stigma toward mental illness still exists. Stigma can result in inadequate care for people with mental illnesses. Students come into nursing from a variety of backgrounds and these backgrounds influence their nursing clinical judgments, especially related to caring for people with mental illnesses. A qualitative descriptive analysis was conducted using 60 undergraduate nursing student reflections on their backgrounds and perceptions of mental health stigma. Students wrote about their Previously Held Beliefs and the Influence of Culture, Overcoming Stigma through their Experiences with Friends and Family, Influence of Popular Culture, and Personal Experiences, and their New Understanding of mental illness and what that means for their future nursing practice. These findings have important implications for nursing education including providing more opportunities for nursing students to care for people with mental illnesses, reframing how mental health content is delivered in undergraduate nursing programs, and providing additional support for students with personal mental illnesses.

Determining the frequency of burn wound dressing for clinically competent nursing students: establishing standards based on learning curves

BACKGROUND

The primary objective of clinical practice in nursing education is to achieve mastery of clinical skills through repetitive practice. Therefore, there exists a correlation between the frequency of skill demonstration and clinical competency. This study aimed to address the following question: How many times should a nursing student perform burn wound dressing to attain clinical competency?

METHODS

This time series study was conducted on 41 junior nursing students who were selected through a census sampling method at Neyshabur School of Nursing from spring 2015 to summer 2021. The data collection tool was a researcher-made competency evaluation checklist (CEV). The competency score of each student for each skill demonstraion episode was evaluated using the Competency Evaluation Checklist (CEV) and recorded on the learning curve until a plateau was reached. SPSS16 and repeated measures analysis of variance (ANOVA) were used.

RESULTS

The mean competency score of burn wound dressing was 67.5 ± 11.0 (out of 100) during the first attempt, which increased to 95.9 ± 4.3 by the ninth attempt. The learning curve for the burn wound dressing skill reached a plateau after five attempts. Additionally, by the fifth attempt of dressing the burn wound, all students could accurately identify the depth, extent, and severity of the wound.

CONCLUSIONS

Establishing a standardized frequency for clinical skill performance and ensuring ample practice opportunities can have significant benefits in nursing education systems. These benefits include long-lasting learning, reduced costs, and improved effectiveness. As a result, nurse managers and lecturers should consider the resources available in their educational systems and strive to provide students with adequate opportunities and a supportive environment to practice their skills.

Undergraduate Nursing Student Mental Health Clinical Experiences in Saudi Arabia: Findings From a Qualitative Study

BACKGROUND

Clinical experience is an important way of resolving preregistration challenges. Negative feelings toward pursuing a career in mental health nursing may be modified by well-structured practicums.

AIMS

To explore nursing student perspectives of clinical practicums in mental health in Saudi Arabia for the purpose of enhancement of nurse education in mental health care.

METHODS

This qualitative study used thematic analysis from semistructured focus group interviews of 20 female undergraduate nursing students. Inductive outcomes and emergent conceptual data were reviewed by investigators, doctoral prepared faculty peers, and members of the sample. NVivo 10.1 software was used to suggest conceptual groupings into themes based on inductive codes.

RESULTS

The core theme-enhancement of mental health care skills-comprised four emerging subthemes, including the application of theory for clinical improvement, positive feelings, and motivation toward removal of discrimination and stigmatization, experience with apprehension, anxiety, fear, and stress, and therapeutic communication skills.

DISCUSSION

Clinical placement in mental health-related practice may assist undergraduate nursing students in addressing anxiety and stress related to contacting patients, confronting stigmatizing and negative emotions, applying theoretical knowledge to clinical practice, having therapeutic communication skills, and enhancing overall professional experiences of nursing students. It is hoped that undergraduate clinical mental health placement will contribute valuable skills and viewpoints to nursing students who aim to enter professional practice in all areas and especially mental health.

The development of positive attitudes toward mental health among university nursing students: Countering the role of social desirability

PURPOSE

This study analyses the evolution of attitudes of nursing students towards mental health, paying particular attention to the influence of social desirability.

DESIGN AND METHODS

Prospective longitudinal repeated-measures study in a sample of nursing students who completed the Community Attitudes toward Mental Illness scale and The Social Desirability Scale.

FINDINGS

After their training, and after adjusting for social desirability, students of female gender recognized attitudes that foster humanistic values than their male counterparts. However, attitudes of restrictiveness and authoritarianism continued to be manifested significantly when the students themselves had mental health problems (MHPs), had had previous training, or were older.

PRACTICE IMPLICATIONS

University courses should continue to foster attitudes of acceptance and destigmatization of people with MHPs, through responses that value authenticity.

Nursing Students’ Use of Recovery Stories of People with Mental Illness in Their Experiences: A Qualitative Study

This study clarified nursing students’ experiences of an educational program where they listened to the recovery stories of individuals with mental illness in a classroom setting. In this qualitative study, the program was delivered to third year nursing students in December 2019 (n = 62), after which they completed an anonymous free-response questionnaire. The responses were classified into seven clusters: understanding how patients perceive and appraise nursing care practices; interpreting experiences of disease realistically; deciphering patients’ histories based on their recovery stories; exploring ways to engage with patients based on knowledge of determinants of nursing care quality; finding ways to engage with patients grounded in respect; recognizing the importance of creating a therapeutic environment; gaining a sensitive understanding based on real-world stories. These clusters were grouped into “understanding the quality of nursing practices” and “gaining knowledge for application to nursing practices.”

'What's she doing here?' Overcoming barriers to the implementation of Expert by Experience positions in academia

INTRODUCTION

Experts by Experience involvement in the education of health professionals has gained momentum as an important strategy in ensuring quality, person-centred education. Despite being a requirement for occupational therapy programs in Australia and internationally, involvement is variable and limited. Barriers to the implementation of academic roles have been identified, including negative attitudes of colleagues, systemic barriers, and insufficient evidence of their value. Mental health academics who do not identify as having lived experience (referred to as allies) have provided crucial support for Experts by Experience. Understanding their perspectives on implementation barriers and how they can be addressed is crucial to facilitating a broader level of meaningful involvement.

METHODS

A qualitative exploratory research project was conducted, involving in-depth interviews with mental health academic allies (n = 16) from Australia, Ireland, and New Zealand. Participants were from the disciplines of nursing, occupational therapy, social work, and psychiatry. Data were analysed thematically.

FINDINGS

Two main themes were identified from the data analysis process: convincing colleagues and dealing with university barriers. Participants described varying attitudes from colleagues towards Experts by Experience, with many not understanding or appreciating their contribution to education and student outcomes. At the university level, reluctance to embrace innovation and funding and other resource shortages presented impediments to the implementation of Expert by Experience roles. Participants described using creative measures to overcome institutional barriers and encourage greater acceptance of such roles by colleagues.

CONCLUSION

This research describes how allies experienced and overcame barriers they faced when supporting the implementation of academic positions for Experts by Experience. Allies have an important role to play in overcoming systemic barriers, and the approaches they have taken to achieve this may be an important source of learning for others with similar aspirations.

Perspectives of Nursing Students towards Schizophrenia Stigma: A Qualitative Study Protocol

Aim: This study aims to explore fourth-year nursing students’ knowledge of schizophrenia and their attitudes, empathy, and intentional behaviours towards people with schizophrenia. Design: This will be a descriptive qualitative study using focus-group interviews. Methods: Fourth-year nursing students on clinical placement in a hospital in Hunan province will be invited for focus-group interviews. Snowball and purposive sampling will be used to recruit nursing students for this study. Five focus-group interviews, each including six participants, will be conducted to explore participants’ knowledge, attitudes, intentional behaviours, and empathy towards schizophrenia. The interview will be conducted through the online Tencent video conference platform and the interview data will be collected through the same platform. All interviews will be recorded and transcribed verbatim and analysed with the approach of the content analysis supported by NVivo 12. Simultaneous data collection and analysis will be performed, and the interviews will be continued until data saturation is met. The findings of this study will be helpful in developing effective interventions to decrease the stigma toward schizophrenia among nursing students and those who study healthcare disciplines.

Study on Nursing Effect of Psychological Intervention on Uremic Hemodialysis Patients

Aim

Patients in the hemodialysis stage are prone to psychological pressure of depression and anxiety and have resistance, which affects the clinical treatment effect. Effective psychological intervention plays a very important role in improving patients' psychological pressure and patients' compliance. The aim of this study is to explore the nursing effect of psychological intervention on uremic hemodialysis patients.

Methods

There were 126 uremic hemodialysis patients admitted to the hospital from August 2020 to December 2021. The patients were randomly divided into the routine nursing care group (n = 63) and psychological intervention group (n = 63). The routine nursing care group received routine nursing care for uremia hemodialysis patients. The psychological intervention group implemented psychological intervention on uremia hemodialysis patients. The methods of psychological intervention mainly include establishing a good nurse-patient relationship, popularizing hemodialysis knowledge, timely psychological counseling for patients, and organizing patient communication meetings. The treatment compliance, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) of the two groups were compared before and after nursing. SF-36 scale was used to evaluate the quality of life of patients. The incidence of complications and nursing satisfaction were compared between the two groups.

Results

The treatment compliance rate and nursing satisfaction of hemodialysis uremic patients in the psychological intervention group were significantly higher than the routine nursing care group. The SAS and SDS of hemodialysis uremia patients in the psychological intervention group were significantly lower than the routine nursing care group after psychological intervention, and SF-36 scale was significantly higher than the routine nursing group. The main complications of uremic hemodialysis patients are hypotension, hyperkalemia, internal fistula occlusion, and infection. Compared with the routine nursing care group, the incidence of complications in the psychological intervention group was significantly reduced.

Conclusion

The implementation of psychological nursing intervention for uremic hemodialysis patients have a very significant effect on reducing the incidence of complications and improving anxiety, depression, treatment compliance, and the quality of life and the nursing satisfaction.

Changing 'the world for the better': motivations of mental health academics for supporting expert by experience roles in mental health education

BACKGROUND

Despite demonstrating positive outcomes in education, academic positions for Experts by Experience in mental health have not been widely implemented. To date positions have been driven by individual champions (allies). Their motivation for this support has not yet been researched.

AIMS

To deepen understanding of motivations of mental health academics who have championed and supported implementation of EBE positions.

METHODS

A Qualitative exploratory, study was undertaken involving in-depth individual interviews with 16 academics with experience of actively supporting the implementation of Expert by Experience positions in academia. Data were analysed independently by two researchers using a structured thematic framework.

RESULTS

Motivations commonly arose from allies' own experiences of working with or exposure to Experts by Experience. Other motivating factors included: belief in the value of specific knowledge and expertise Experts by Experience contributed to mental health education; and, identifying the essential role Experts by Experience play in meeting policy expectations, and the broader philosophy of the university.

CONCLUSIONS

The motivations identified by allies in this study have implications for Expert by Experience roles. Deeper understanding of motivations to support these roles is essential to arguing for their value, and ultimately producing positive outcomes in the education of health professionals.

Renaming Schizophrenia and Stigma Reduction: A Cross-Sectional Study of Nursing Students in Taiwan

Schizophrenia is one of the most stigmatized mental disorders. In 2014, schizophrenia was renamed in Mandarin in Taiwan, from the old name of “mind-splitting disease” to new name “disorder with dysfunction of thought and perception”, in an attempt to reduce the stigmatization of schizophrenia. This cross-sectional study aimed to investigate the effects of renaming schizophrenia on its stigma in nursing students. We examined the public stigma, self-stigma, and social distance associated with schizophrenia and compared them before and after the renaming. Basic demographic data and previous contact experience were collected, and participants completed a modified Attribution Questionnaire, the Perceived Psychiatric Stigma Scale, and modified Social Distance Scale. The final sample comprised 99 participants. Assessment revealed that the renaming significantly reduced public stigma, self-stigma, and social distance. Regarding the old and new names for schizophrenia, the fourth-year nursing students scored significantly higher on public stigma and self-stigma than did the first-year students. Personal exposure to individuals diagnosed with mental disorders reduced public stigma toward schizophrenia. The study findings suggest that the renaming of schizophrenia reduced its associated stigma. Providing accurate information, instruction by qualified tutors, as well as exposure to patients in acute exacerbation in hospital settings and recovered patients in the community are important. Further studies with longitudinal design, participants from diverse backgrounds, and larger sample sizes to investigate the effect of renaming on the stigma toward schizophrenia are warranted.

Conceptualising Recovery in Mental Health Nursing: A Word, A Journey or A Philosophy of Nursing Care?

Purpose: It is important for undergraduate mental health nursing students to develop an understanding of what recovery means in contemporary mental health nursing in order to practise in accordance with current models of care. However this concept can prove challenging for some. This paper looks at one particular undergraduate mental health nursing course with the aim of evaluating how effectively recovery is embedded in the course. Methods: Course material related to recovery and possible barriers to understanding of recovery, including both those contained in this particular undergraduate mental health nursing course and those which come from external factors, are discussed. Results: Ways to promote a better understanding of recovery-oriented mental health nursing care are suggested. Conclusions: To promote a greater understanding of recovery in mental health nursing there needs to be a better match between the consumer experience, educational materials provided in the course, tutor perspectives, student focus and assessment methods.

Time Waits for No One: Longitudinal Study on the Effects of an Anti-Stigma Seminar on the Psychology Student Population

The primary aim is to describe the changes in the knowledge of mental health conditions, the attitudes toward the mentally ill, and the intended behaviour towards people with mental illness among the entire student population of the third year of a degree course in Psychology. A total of 570 students attended a seminar on stigma towards mental illness and were invited to complete an online survey which collected data on sociodemographic characteristics and three validated questionnaires evaluating different aspects of stigma at three different time points (pre-intervention, post-intervention, and at one year follow up). A total of 253 students (44.39%) completed the questionnaires at t0, t1, and t2. The mean age of the sample was 23.7 (SD = ±5.89), and 86.96% (n = 220) were females. Between t0 and t1, a statistically significant improvement was observed for all three outcomes, while the intended behaviour outcome was no longer significant between t1 and t2 (Z = −0.70; p = 0.48). Females and who participated live at the seminar maintained a significant knowledge of mental illness and a better attitude toward community mental health care. The effects of the seminar focused on reducing stigma tended to diminish over time at one year follow-up, particular in relation to intended behaviour.