Ng Yin Ping, Rashid Abdul, O'Brien Finian
Department of Psychiatry, Penang Medical College, Penang, Malaysia.
Department of Public Health, Penang Medical College, Penang, Malaysia.
PLoS One. 2017 Nov 13;12(11):e0187861. doi: 10.1371/journal.pone.0187861. eCollection 2017.
Mental illness-related stigma is common, and is associated with poorer outcomes in people with mental illness. This study evaluated the attitudes of primary care nurses towards people with mental illness and its associated factors; and the effectiveness of a short video-based contact intervention (VBCI) in improving these attitudes using a Malay version of the 15-item Opening Minds Stigma Scale for Healthcare Providers (OMS-HC-15-M).
A 5-minute VBCI was developed comprising elements of psychoeducation and interviews of people with mental illness and the people they interact with, relating to experience of mental illness and recovery. A pre-post cross-sectional study was conducted on 206 randomly selected primary care nurses in Penang, Malaysia. The OMS-HC-15-M questionnaire was administered before and immediately after participants viewed the VBCI. The difference in mean pre-post VBCI scores using paired t-tests, effect size and standardised response mean (SRM) were obtained. Factors correlating to attitudes were obtained using univariate and multivariate regression analyses.
Differences in pre-post VBCI score were statistically significant (p<0.001) with a 14% score reduction, a moderate effect size and SRM at 0.97 (0.85-0.11) and 1.1 (0.97-1.2) respectively. By factoring in the Minimal Detectable Change statistic of 7.76, the VBCI produced a significant improvement of attitudes in 30% of the participants. Factors associated with less stigmatising attitudes at baseline were previous psychiatry-related training, desiring psychiatric training, and positive contact with people with mental illness.
This is the first study in Malaysia to show that a brief VBCI is effective in improving attitudes of primary care nurses towards people with mental illness in the immediate term. Further studies are needed to determine if these results can be sustained in the longer term and generalizable to other health care professionals. Qualitative studies are warranted to provide insight to the factors correlating to these attitudes. (300 words).
与精神疾病相关的污名化现象普遍存在,且与精神疾病患者较差的治疗结果相关。本研究评估了初级护理护士对精神疾病患者的态度及其相关因素;并使用马来语版的15项医疗服务提供者消除偏见量表(OMS-HC-15-M),评估基于视频的简短接触干预(VBCI)在改善这些态度方面的有效性。
制作了一个5分钟的VBCI,包含心理教育内容以及对精神疾病患者及其互动对象就精神疾病经历和康复情况进行的访谈。对马来西亚槟城随机抽取的206名初级护理护士进行了一项前后测横断面研究。在参与者观看VBCI之前和之后立即发放OMS-HC-15-M问卷。使用配对t检验、效应量和标准化反应均值(SRM)得出VBCI前后平均得分的差异。通过单变量和多变量回归分析获得与态度相关的因素。
VBCI前后得分差异具有统计学意义(p<0.001),得分降低了14%,效应量中等,SRM分别为0.97(0.85 - 0.11)和1.1(0.97 - 1.2)。考虑到最小可检测变化统计量为7.76,VBCI使30%的参与者态度有显著改善。基线时与较少污名化态度相关的因素包括以前的精神病学相关培训、渴望接受精神病学培训以及与精神疾病患者的积极接触。
这是马来西亚第一项表明简短VBCI能在短期内有效改善初级护理护士对精神疾病患者态度的研究。需要进一步研究以确定这些结果能否长期维持并推广到其他医护专业人员。有必要进行定性研究以深入了解与这些态度相关的因素。 (300字)