Students' mental health clinical placements, clinical confidence and stigma surrounding mental illness: A correlational study

Nurses' experiences when conducting the mental state examination (MSE): A scoping review

The Mental State Examination (MSE) is an assessment framework used to facilitate the collection of subjective and objective data about a person's current mental state. There is a lack of understanding of nurses' experiences when conducting the MSE. The aim of this scoping review is to identify, examine and summarize the available literature relating to nurses' experiences when conducting the MSE. A scoping review was conducted using Arksey and O'Malley (2005) framework to review, examine and synthesize the available literature on nurses' experiences with the MSE. A PRISMA flow diagram was used to describe the systematic literature search. Six databases (APA PsycInfo, CINAHL, MEDLINE, PubMed, ProQuest, and Scopus) were searched including reference lists of eligible sources. Google Scholar, Trove and Proquest Dissertation and Thesis were searched for grey literature. Twelve articles included in this scoping review considered nurses experiences when conducting the MSE. The principles of thematic analysis were used to synthesize the studies. Three distinct themes were identified from the literature: (i) Nurses' role and the MSE, (ii) Nurses' competence and knowledge when conducting the MSE, and (iii) Nurses' confidence when conducting the MSE. The results of this scoping review identified the MSE as a component of the mental health nursing role and a core competency of mental health telephone triage services. The MSE was used by nurses in the Emergency department (ED), acute in-patient and community mental health settings, including mental health telephone triage services. Nurses working in EDs and acute in-patient mental health settings experienced a lack of confidence and competence, including a knowledge deficit in conducting the MSE in comparison to nurses working in community mental health settings. Community mental health nurses identified the importance of conducting an MSE higher than acute in-patient mental health nurses. This review identified the need for evidence-based research related to the MSE and its application in nursing practice. Evidence-based research will inform the development of MSE guidelines and policies, thus, enhance mental health nursing practice related to the MSE, including improving and strengthening consumer-nurse therapeutic alliance in acute in-patient mental health settings.

Nursing students' attitudes towards mental illness: A multi-national comparison

Accessible Summary What is known on the subject Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi-national comparisons of nursing students' attitudes towards mental illness. What this paper adds to existing knowledge This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. What are the implications for practice Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness.

ABSTRACT

INTRODUCTION: Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help-seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi-national perspective.

AIM

To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA.

METHOD

In a cross-sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one-way analysis of variance was used to compare differences between countries.

RESULTS

Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest.

DISCUSSION

Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences.

IMPLICATIONS FOR PRACTICE

It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution.

Experiences of nursing students during their mental health clinical training at a general hospital in Namibia

BACKGROUND

 Clinical training is important because it constitutes more than half of the formal courses in nursing education. Accordingly, it is important for institutions of higher learning to continually explore the experiences of nursing students during their clinical placement. These experiences can be used to promote a positive clinical learning environment for students. However, the experiences of nursing students during their mental health clinical training in Namibia have not been extensively researched.

OBJECTIVES

 The aim of this study was to explore and describe the experiences of nursing students during their mental health clinical training at a general hospital in Namibia.

METHOD

 A qualitative, exploratory, descriptive and contextual research design was followed as the basis for conducting the study. A sample of 15 nursing students was conveniently selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes.

RESULTS

 The following three themes emerged: collating theory and mental health practice experiences, facing challenges in clinical placements, and recommendations to ensure effective learning about mental health.

CONCLUSION

 The use of a general hospital for clinical placements within an undergraduate nurse training course led to some concerns regarding the relevance and appropriateness of such experience within a nursing programme.Contribution: The findings have important implications for the training of undergraduate nursing students in general hospitals. It can be utilised to develop strategies to improve positive clinical practice placement and develop clinical skills for undergraduate nursing students in general hospitals.

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.

Exploring the benefits and challenges of being a consumer educator in nursing education: A scoping review

What is known on the subject The mental health needs of individuals are increasing following the COVID-19 pandemic, with a need to focus on the education of nurses to be equipped to respond. Stigma around mental health still exists for nursing students, with the implementation of mental health education by an individual with lived experience having a known positive effect on stigmatizing attitudes. Research on consumer involvement in nursing education identifies that the consumer role is often varied and casual, with no existing review on the consumer experience. What the paper adds to existing knowledge The study emphasizes the importance of consumer involvement in nursing education. Alongside the literature focussing on the student benefits, this review highlights both the benefits of being an educator, and the challenges of being an educator from the consumer's perspective. IMPLICATIONS FOR PRACTICE: The knowledge around the consumer perspective mapped in this review has the potential to impact and transform education protocols for consumer involvement in education. This can maximize on the meaningful contribution that lived experience has within mental health nursing education. This review enforces the need for an awareness of the challenges consumers face in their role as an educator, and highlights the need for further understanding of how to overcome these challenges. There is also an opportunity to capitalize on the benefits identified by consumers in their role within nursing education and sharing their lived experience. ABSTRACT: Introduction While the mental health needs of populations are increasing, the targeted training of mental health professionals, specifically nurses, is required. Stigma surrounding mental health from nursing students exists, highlighting educational gaps. To address this, the involvement of consumers in undergraduate education has resulted in a positive effect on the stigmatizing attitudes of nursing students. There is still a limited understanding, however, of the consumers experience in this process. Aim To explore the experiences of individuals living with mental illness in educating nursing students. Methods The Joanna Brigg's Institute's (JBI) methodology for scoping reviews was used to search CINAHL, Medline, PsychInfo, Web of Science and Scopus including grey literature. The eligibility criteria for participants included individuals (a) diagnosed with a mental illness; (b) over 18 years of age; and (c) who participated in the educating of nursing students surrounding mental health in any context. Articles were only considered that were in the English language, and no time constraint was enforced during the search strategy for article selection. The search yielded 2640 results, of which 26 articles were included. Results Results found two prominent categories, including both benefits and challenges of being the educator from the consumer perspective. The benefits included: (a) the person behind the diagnosis; (b) reciprocal relationships; (c) positive effects on well-being; (d) unique contribution; and (e) purpose in storytelling. Challenges identified included: (a) vulnerability; (b) voyeuristic; (c) lack of preparation; (d) negative effects on well-being; (e) support; (f) not a real consumer; (g) variation of involvement; and (h) acknowledging consumer perspective. Discussion As consumer-led education for mental health nursing curriculum becomes mandated, amplifying the voice of the consumer in nursing education is crucial. While the benefits and challenges voiced by consumers in their involvement in mental health nursing education have been outlined here, further knowledge focussed on the consumer's experience as an educator outside the classroom setting, and in clinical practicum, alongside consumer involvement in specialized mental health education sessions, could aid in transforming consumer involvement. Implications for practice This review offers an incentive for nurse educators to capitalize on the benefits of educating for consumers to promote a meaningful contribution, while also practicing with an awareness of voiced challenges.

The factors and outcomes of stigma toward mental disorders among medical and nursing students: a cross-sectional study

BACKGROUND

Medical and nursing students' attitudes toward mental disorders have a large impact on their working intentions in mental health settings and patients' health outcomes. However, there are few studies about the stigma toward mental disorders among medical and nursing students in China.

METHODS

In this cross-sectional study, a total of 838 medical and nursing students completed questionnaires on their sociodemographic characteristics and familiarity with people diagnosed with mental disorders as well as the Community Attitudes toward Mental Illness Scale (CAMI). The stigma was compared between medical students and nursing students by ANOVA. A multiple logistic regression model was built to explore the relationships among sociodemographic characteristics, familiarity with mental disorders and stigma.

RESULTS

The total mean score of the CAMI was 137.61 (SD = 15.63). The score for authoritarianism (M = 33.33, SD = 3.62) was the lowest score of the four subscales. Medical students showed more positive attitudes toward mental disorders than nursing students. However, after controlling the co-variables, the difference disappeared. Stigma was significantly associated with students' education, area of residence, marital status, economic status, history of mental disorders and familiarity with mental disorders.

CONCLUSIONS

Medical and nursing students show a negative attitude toward mental illness to a certain degree, especially regarding the view that people with mental disorders are inferior. Higher education level, residence in urban areas, single marital status, better economic status, and better familiarity with mental disorders may be related to less stigma among medical and nursing students.

Analysis of Stigma in Relation to Behaviour and Attitudes towards Mental Health as Influenced by Social Desirability in Nursing Students

The training undergraduate nursing students receive, both in terms of theoretical input and clinical practice, may help to instil a less stigmatising perception of mental health. To analyse the perceived evolution of attitudes and expected behaviours, a longitudinal repeated measures study was conducted in a population of student nurses during their undergraduate mental health education. The Mental Illness: Clinicians’ Attitudes Scale, a Scale for measuring attitudes to the mentally ill among future Health workers, and the Reported and Intended Behaviour Scale were completed. A mixed linear model was used to assess the effect of each factor in the questionnaires before and after the various stages of the students’ training in mental health. The overall effect of each factor was assessed by testing the interaction between factor and group, both with and without adjustment with the Social Desirability Scale. The results showed that the clinical practice stage, due to the proximity to care for people with mental health problems, improves attitudes and behaviours towards mental health in students who have not had mental health problems, and also in younger students. In conclusion, integrated, holistic training during the period of clinical practice was associated with positive changes in the attitudes and intended behaviour.

Effects of the psychiatric nursing course on students' beliefs toward mental illness and psychiatric nursing perceptions in Turkey

PURPOSE

To investigate the effects of the psychiatric nursing course on students' beliefs toward mental illness and psychiatric nursing perceptions.

DESIGN AND METHODS

This experimental study was carried out with 80 students enrolled for the psychiatric nursing course.

FINDINGS

The mean score of the Beliefs toward Mental Illness Scale decreased, and the mean score of the Psychiatric Nursing Perception Scale increased after the course. The difference between the measurements was statistically significant (p < 0.05).

PRACTICE IMPLICATIONS

This study shows that psychiatric nursing course is effective in decreasing students' negative beliefs toward mental illness and increasing positive psychiatric nursing perceptions. Students' attitudes about mental illness and psychiatric nursing should be determined from the very first year of their education, and their negative beliefs should be intervened with.

Registered nurse preceptors' perceptions of changes in the organisation of clinical placements in psychiatric care for undergraduate nursing students: A mixed-methods study

AIM

The aim of this study was to investigate the perceptions of registered nurse (RN) preceptors working in psychiatric care concerning the organisation of clinical placements and their own preceptor role with undergraduate nursing students.

BACKGROUND

Clinical placements play a central role in undergraduate nursing education, and it is crucial that psychiatric care clinical placements are of high quality.

METHODS

The RNs' perceptions before and after the introduction of changes in the organisation of clinical placements were compared. A total of 103 surveys with quantitative and qualitative data were returned, from 59 RN preceptors at baseline and 44 RN preceptors at follow-up. Data were analysed with non-parametrical statistics and qualitative content analysis.

RESULTS

The majority of RN preceptors perceived the changes to have been beneficial, but there was still a desire for the students to have more time in their psychiatric care clinical placements according to the RN preceptors. At follow-up, significantly more RN preceptors perceived that they had an intentional pedagogical foundation for their precepting.

CONCLUSIONS

We conclude that the changes introduced into the clinical placement are beneficial, but there is still need for further improvement in relation to the amount of time student nurses spend in psychiatric clinical placements and in the opportunities provided for RN preceptors to attend preceptor preparation courses.

Moral intelligence, clinical placement experience and professional behaviors among Iranian undergraduate nursing students in a baccalaureate nursing program: A descriptive correlational study

AIMS

This study was intended to examine the relationship of both moral intelligence (MI) and Clinical Placement Experience (CPE) with the level of nursing students' professional behaviors (PB).

BACKGROUND

The foundation of belief, belonging and ethical values develop PB as a meaningful attribute during the period students and caring for patients.

DESIGN

A descriptive correlational study was conducted.

METHODS

Descriptive data were derived from the Belongingness Scale-Clinical Placement Experience (BES-CPE), the Moral Intelligence Questionnaire (MIQ) and the Nursing Students Professional Behaviors Scale (NSPBS) including 200 students (response rate 94.5%).

RESULTS

We found a statistically strong positive correlation between NSPB, MI and CPE. The regression model accounted for 57.8% of the variance in NSPB; CPE and MI were significant explanatory variables of NSPB. Moreover, the non-employed dormitory students had a significant statistical difference in the scores of all three variables. Female students had significantly higher CPE and MI (p˂0.05).

CONCLUSIONS

According to our findings, preventive and mediation endeavors for nursing students can explicitly target their behavioral skills to reduce perceived rejection and improve morality. As a result, an optimal plan to improve the quality of professional training courses for students should be designed based on the comprehension of clinical belonging and moral intelligence.

Experiences of nursing students during clinical education in mental health clinics: A phenomenological qualitative study

AIM

Nursing students have both positive and negative experiences during clinical education. This study was conducted to identify experiences of nursing students during clinical education in mental health clinics.

DESIGN

This phenomenological qualitative design study was conducted with 4th year undergraduate nursing students from a university in Turkey to identify their experiences specifically in mental health clinics.

METHODS

The data were collected using focus groups interviews with 40 nursing students and assessed with the 7-stage phenomenological analysis method described by Colaizzi.

RESULTS

Three main themes were determined: (i) the need for supportive interventions to cope with negative emotions; (ii) difficulty in translating theoretical knowledge into practice; and (iii) the lack of role model nurses and teaching staff.

CONCLUSIONS

The results of this study indicate that supportive interventions should be given to nursing students before clinical education. Also, the duration of clinical education, the teaching methods to be used and role model nurses and teaching staff effectiveness in clinical education should be planned carefully.

The impact of an undergraduate students' culture on their learning about mental health: A scoping review

Mental disorders are highly prevalent. This necessitates undergraduate students in health-related courses are provided with the knowledge, skills, and attitudes to deliver safe care. Research confirms undergraduate health students maintain discriminative, stigmatizing, and inaccurate beliefs and attitudes toward those experiencing mental disorders. However, there is a paucity of research exploring how culture influences these beliefs. This scoping review addressed the question: 'What is the impact of an undergraduate student's culture on their learning about mental health?' A systematic search was undertaken of the MEDLINE, CINAHL, Scopus, PsycINFO, and ERIC databases. Results indicate variance between students' cultural beliefs in their attitudes toward and knowledge of mental disorders and understanding of interventions and treatment. None of the identified studies reviewed the ramifications for pedagogy beyond anecdotal suggestions. Educators need to acknowledge the potential impact that students' cultural beliefs have on their learning about mental health and consider appropriate learning activities to acknowledge the role of culture. Research of the impact of undergraduate students' culture on their learning about mental health will provide an evidence base for the development of these learning activities.

Exploring pedagogies used in undergraduate mental health nursing curriculum: An Integrative Literature Review

The growing demand of mental health services among the population and the stigma associated with mental health conditions have resulted in a shortage of skilled nurses competent in delivering quality care to persons experiencing mental health conditions. This suggests the need to develop a systematic and comprehensive curriculum to prepare nursing students for a career in mental health nursing. An integrative review on empirical studies was conducted based on Cooper's five-stage integrative review framework to investigate the different pedagogies and to highlight the elements of an effective curriculum for teaching mental health nursing. All quantitative, qualitative, and mixed-method studies published between 2009 and 2019 that examined pedagogies in mental health nursing for nursing undergraduates were included in this review. Databases of interest included PubMed, Cochrane, PsycINFO, Embase, Scopus, Web of Science, and ProQuest Dissertations and Theses. To ensure methodological rigour and validity, the 23 included studies were independently evaluated by two authors through critical appraisal tools developed by Joanna Briggs Institute for quantitative and qualitative studies. Results from this review were categorized into three themes: (i) the deployment of simulation; (ii) pedagogies in enhancing critical thinking; and (iii) importance of consumer-oriented educational experiences. These results suggested that students would benefit substantially from in-depth discussions, critical reflections, and real-life experiences. Mental health nursing curricula should incorporate simulations, pedagogies for critical thinking, and consumers' lived experience to supplement the clinical rotations.

Outcomes of Consumer Involvement in Mental Health Nursing Education: An Integrative Review

This integrative review analyzed the research on consumer involvement in mental health nursing education in the last decade. We aimed to derive the main contents, methods, and outcomes of education using consumer involvement for mental health nursing students. We searched six electronic databases using English and Korean search terms; two authors independently reviewed the 14 studies that met the selection criteria. Studies on the topic were concentrated in Australia and some European countries; most of them used a qualitative design. The main education subject was recovery, and consumers tended to actively participate in education planning. Moreover, students’ perceptions about education using consumer involvement and people with mental health problems changed positively, as well as their experiences of participating in mental health nursing education. There is a lack of interest in the topic in Asian countries, including Korea. Thus, future studies in Asian countries are needed to conduct qualitative and in-depth explorations of students’ experiences regarding an educational intervention that uses consumer involvement as a tool rigorously designed for mental health nursing education. Consumer involvement can be an innovative strategy to produce high-quality mental health nurses by minimizing the gap between theory and practice in the undergraduate program.