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Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019

WHAT IS KNOWN ON THE SUBJECT? Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or rest...

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Autores principales: Dickens, Geoffrey L., Schoultz, Mariyana, Hallett, Nutmeg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790366/
https://www.ncbi.nlm.nih.gov/pubmed/35147265
http://dx.doi.org/10.1111/jpm.12826
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author Dickens, Geoffrey L.
Schoultz, Mariyana
Hallett, Nutmeg
author_facet Dickens, Geoffrey L.
Schoultz, Mariyana
Hallett, Nutmeg
author_sort Dickens, Geoffrey L.
collection PubMed
description WHAT IS KNOWN ON THE SUBJECT? Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint). It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE? To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research. By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. WHAT ARE THE IMPLICATIONS FOR PRACTICE? Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice. There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments. Training programmes that focus on attitudinal change need to be more rigorously evaluated. ABSTRACT: INTRODUCTION: Attitudes are considered integral to mental health nursing practice. AIMS: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. METHODS: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. RESULTS: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. DISCUSSION: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. IMPLICATIONS FOR PRACTICE: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links.
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spelling pubmed-97903662022-12-28 Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019 Dickens, Geoffrey L. Schoultz, Mariyana Hallett, Nutmeg J Psychiatr Ment Health Nurs Review Articles WHAT IS KNOWN ON THE SUBJECT? Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint). It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE? To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research. By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. WHAT ARE THE IMPLICATIONS FOR PRACTICE? Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice. There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments. Training programmes that focus on attitudinal change need to be more rigorously evaluated. ABSTRACT: INTRODUCTION: Attitudes are considered integral to mental health nursing practice. AIMS: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. METHODS: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. RESULTS: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. DISCUSSION: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. IMPLICATIONS FOR PRACTICE: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. John Wiley and Sons Inc. 2022-02-23 2022-12 /pmc/articles/PMC9790366/ /pubmed/35147265 http://dx.doi.org/10.1111/jpm.12826 Text en © 2022 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Articles
Dickens, Geoffrey L.
Schoultz, Mariyana
Hallett, Nutmeg
Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title_full Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title_fullStr Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title_full_unstemmed Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title_short Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019
title_sort mental health nurses' measured attitudes to people and practice: systematic review of uk empirical research 2000–2019
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790366/
https://www.ncbi.nlm.nih.gov/pubmed/35147265
http://dx.doi.org/10.1111/jpm.12826
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