Li Li, Lu Shurong, Xie Chunyan, Li Yamin
Xiangya School of Nursing, Central South University, Changsha, China.
Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China.
Front Psychiatry. 2023 Aug 1;14:1180034. doi: 10.3389/fpsyt.2023.1180034. eCollection 2023.
Negative attitudes of nurses toward mental disorders have been reported in various countries. Nurses' stigmatizing attitudes can harm patients with mental disorders (PWMD), thereby delaying the provision of help to patients and leading to decreased quality of care. In this study, we aimed to assess Chinese nurses' stigmatizing attitudes toward patients with mental illness and provide a basis for future development and testing of appropriate and culturally adapted interventions to reduce it.
This study aimed to assess the attitudes of Non-mental Health Nurses (NMHNs) in general hospitals in China toward the stigma of PWMD and determine the factors influencing them.
A cross-sectional survey of NMHNs in general hospitals were conducted. A self-designed WeChat-based questionnaire was used that included demographic information about the need for training on mental health issues. Participants were provided with a vignette of a depression case with suicidal thoughts. The Depression Stigma Scale (DSS) and Social Distance Scale (SDS) were used to assess attitudes toward mental disorders. Nine questions on the adequacy of knowledge about anxiety and depression and the current status of scale use were used to assess the current status of training needs for mental disorders. Descriptive analysis, chi-square test, and multivariate logistic regression were used for the table.
A total of 8,254 nurses in non-mental health professions participated in this study. The mean DSS score of NMHNs was (17.24 ± 6.700), and the SDS score was (10.34 ± 3.154). The total detection rate of stigma among the survey respondents was 13.40% (1,107/8254). Multivariate logistic regression showed that age between 30 and 39 years [ = 0.001, OR = 1.427 (1.154-1.764)], 4 years of work experience and above [ = 0.018, OR = 1.377 (1.056-1.796)], having a bachelor's degree [ < 0.001, OR = 0.742 (0.647-0.851)], adequate psychological knowledge [ < 0.001, OR = 1.567 (1.364-1.799)], full knowledge of communication with patients with anxiety and depression [ < 0.001, OR = 1.848 (1.389-2.459)], and the need to acquire skills to identify anxiety and depression were the influencing factors associated with stigma [ < 0.001, OR = 0.343 (0.236-0.499)].
Stigmatizing attitudes toward PWMD exist among NMHNs in general hospitals in China. Thus, more mental health education programs for NMHNs are needed. Factors associated with higher morbidity stigma can be used to develop appropriate interventions to improve NMHNs' stigmatizing attitudes and provide better quality care to PWMD.
各国均有报道称护士对精神障碍存在负面态度。护士的污名化态度会伤害精神障碍患者（PWMD），从而延误对患者的救助，并导致护理质量下降。在本研究中，我们旨在评估中国护士对精神疾病患者的污名化态度，并为未来制定和测试适当的、适应文化的干预措施以减少这种态度提供依据。
本研究旨在评估中国综合医院非精神科护士（NMHNs）对PWMD污名化的态度，并确定影响这些态度的因素。
对综合医院的NMHNs进行横断面调查。使用自行设计的基于微信的问卷，其中包括关于心理健康问题培训需求的人口统计学信息。为参与者提供一个有自杀念头的抑郁症病例 vignette。使用抑郁污名量表（DSS）和社会距离量表（SDS）来评估对精神障碍的态度。关于焦虑和抑郁知识的充分性以及量表使用现状的九个问题用于评估精神障碍培训需求的现状。对表格进行描述性分析、卡方检验和多因素逻辑回归分析。
共有8254名非精神科专业护士参与了本研究。NMHNs的DSS平均得分为（17.24±6.700），SDS平均得分为（10.34±3.154）。调查对象中污名的总检出率为13.40%（1107/8254）。多因素逻辑回归分析显示，30至39岁[P = 0.001，OR = 1.427（1.154 - 1.764）]、工作4年及以上[P = 0.018，OR = 1.377（1.056 - 1.796）]、拥有本科学历[P < 0.001，OR = 0.742（0.647 - 0.851）]、具备充分的心理学知识[P < 0.001，OR = 1.567（1.364 - 1.799）]、充分了解与焦虑和抑郁患者沟通[P < 0.001，OR = 1.848（1.389 - 2.459）]以及需要掌握识别焦虑和抑郁的技能是与污名相关的影响因素[P < 0.001，OR = 0.343（0.236 - 0.499）]。
中国综合医院的NMHNs对PWMD存在污名化态度。因此，需要为NMHNs开展更多的心理健康教育项目。与较高发病率污名相关的因素可用于制定适当的干预措施，以改善NMHNs的污名化态度，并为PWMD提供更高质量的护理。
