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.

A Testimony of Christian Drug Rehabilitation: Transformed by the Power of God.

ABSTRACT: Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)-translated and summarized in this article-of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.

The Journey From Drug Addiction to Drug Withdrawal: A Christian Gospel Rehabilitation Program in Taiwan.

BACKGROUND: World Drug Report estimates the number of opioid users at 53 million and identifies opioids as responsible for two thirds of the 585,000 people who died as a result of drug use in 2017. PURPOSE: The purpose of this study was to analyze the testimonies of 30 people regarding their journeys from drug addiction to drug withdrawal in Taiwan. METHODS: This was a qualitative research design. The sample inclusion criteria were as follows: (a) being a drug abuser, (b) completed the Christian Gospel Drug Withdrawal Program or church-sponsored program, and (c) shared their related testimony on the Good TV television channel in Taiwan. The participants' stories were posted in Chinese, transcribed by the author, and translated from Chinese into English. Content analysis was used to identify the major themes. RESULTS: Of the 30 participants, 24 were male (80%) and six were female (20%). The major themes identified in their testimonies were: (a) Using illegal drugs related to peer recognition, lack of knowledge, and temptations; (b) drug addiction was an endless pain cycle; (c) turning points related to love, repentance, and hope; (d) drug withdrawal was related to avoiding temptation and overcoming the drug withdrawal syndrome through the Holy Spirit; and (e) outcomes were faith and new life. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: In this study, people who received the gospel drug withdrawal programs expressed that their lives had changed, they had withdrawn from drugs successfully, they had become volunteers to help others, and interactions with their family had improved. These programs may be applied in the mental health nursing profession.

A Comparison of Psychological Well-Being, Coping Strategies, and Emotional Problems Between Taiwanese and Australian Nursing Students.

BACKGROUND: Nursing professional health courses have been reported to be very exhaustive and stressful, with most nursing students reporting moderate levels of stress. PURPOSE: This study was designed to compare the spiritual well-being, coping strategies, psychological well-being, anxiety, depression, and suicidal ideation between Taiwanese and Australian nursing students. METHODS: Three hundred eighty-one nursing students (180 from Taiwan and 201 from Australia) were recruited for this cross-sectional comparative research study. The Psychological Well-being Scale, Spiritual Well-being Scale, Coping Strategies Inventory Short-Form, Hamilton Anxiety Scale, Zung Depression Scale, and Brief Screen for Adolescent Depression Scale were used to collect data. SPSS 27.0 was used for data analysis. Descriptive data analysis, chi-square tests, independent t test, Pearson correlations, and stepwise multiple regressions were used to examine the research questions. RESULTS: Students in Australia had higher mean scores than Taiwanese nursing students for psychological well-being, life satisfaction/self-actualization, and using problem-focused disengagement coping strategies, whereas Taiwanese students had higher mean scores for using emotion-focused engagement coping strategies and depression than their Australian nursing students. Spiritual well-being and problem-focused disengagement were shown to be significantly and positively related to psychological well-being and significantly and negatively related to anxiety, depression, and suicidal ideation in both groups. No significant difference between Australian students and Taiwanese students was found in anxiety, suicidal ideation, and negative-emotion-related alcohol use. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The multiple regressions performed in this study support life satisfaction/self-actualization and the emotion-focused disengagement coping strategy as significant predictors of anxiety, depression, and suicidal ideation in both student groups. The findings of this study help nursing program faculty better understand the key factors of influence on nursing student mental health and provide a conceptual framework for using problem-focused coping strategies and spiritual education on students.

Path Analysis Testing the Development of Personality and Psychological Well-being Model.

The purpose of this study was to test the development of personality and psychological well-being model. This was a cross-sectional, descriptive design. The 448 participants were recruited from older adults living in a Midwest community in the United States. After Institution of Research Board approval, the trained researchers explained this study to older adults who lived in the community. After agreeing to participate, they signed an informed consent form. The structured questionnaires were used to perform data collection. Path analysis was used to examine this model. SPSS 23 version was employed to examine the instruments' reliabilities and descriptive data. In this model, family interaction and spiritual well-being had significant influences on personality, which had a significant influence on selecting coping strategies. Using different coping strategies influenced on the outcome variables (e.g., psychological well-being and suicidal ideation). The family interaction and spiritual well-being played a critical role on the outcome variables.

Use of Zarit Burden Interview in analysis of family caregivers' perception among Taiwanese caring with hospitalized relatives.

This study was conducted to examine the relationships between family caregivers' perception of caregiving and its influencing factors among Taiwanese with hospitalized relatives. The study used a cross-sectional and descriptive correlational design. A convenience sample of 200 primary caregivers of hospitalized patients diagnosed with cancer, stroke and chronic illness was recruited in a Taiwanese Medical Center; this focus was chosen because cancer, stroke and chronic illness generally require long term care. Data were collected by structured questionnaires. Pearson product-moment correlation and stepwise multiple regression analyses were used to analyse the results of this study. Family caregivers who lacked family support and whose patients' ADL (activities of daily living) dependency was increasing experienced a greater caregiving burden. Family caregivers who had better psychological well-being, better quality of relationship and more caregiving knowledge experienced a lower caregiving burden. Quality of relationship, lack of family support and patients' ADL dependency accounted for 43% of the Zarit Burden Interview variance. The results indicated that family caregivers' perception of caregiving included sacrifice, strain, embarrassment, anger and loss of control. It is vital for nurses to understand these caregiving perceptions and their related factors to provide a holistic care plan.

Prevalence and predictors of suicidal behavior among Mongolian high school students.

The purpose of this study was to examine the prevalence and predictors of suicidal behavior among Mongolian high school students. Females were more likely to have suicidal behavior than males. No close friends, feelings of loneliness, insomnia, self perception of underweight or overweight, carrying a weapon were significant predictors of students' suicidal behavior. Missing school without permission, being bullied and going hungry were also important risk factors of suicidal ideation. Families and Schools are important environments to prevent high students' suicide. Improving students' psychological well being, quality of relationship with people, and support resources are critical to prevent suicidal behavior.

Family carer reactions and their related factors among Taiwanese with hospitalized relatives.

AIM: The purpose of this study was to examine the relationships among family carer reactions and their related factors among Taiwanese with hospitalized relatives. BACKGROUND: In Taiwan, most hospitalized patients have relatives or foreign labourers with them 24 hours a day. Limited research has focused on the reactions of family members who provide care for hospitalized relatives. METHODS: A cross-sectional, correlation design was used. A convenience sample of 200 primary carers of hospitalized patients diagnosed with cancer, stroke, and enduring illness was recruited between 2009 and 2010. Data were collected by structured questionnaires. RESULTS: The findings indicate that participants with a moderate level of family support experienced a moderate impact on health and finances, but a high impact on schedule. Family carers' health status and work time were significantly different between, before and after serving as a carer. The multiple regression model variables accounted for 40.1% of the total family carer reaction variance. Three factors were found to predict significantly greater impact on a family carer: (1) lower scores of caregiving knowledge, (2) increasing patient's activities of daily living dependency and (3) lack of family support. CONCLUSION: It is vital for nurses not only to assess patients' activities of daily living, but also to assess family carers' knowledge of caregiving and the patient's existing family support in developing a plan of care that reduces negative impact on family carers.

Use of the resiliency model of family stress, adjustment and adaptation in the analysis of family caregiver reaction among families of older people with congestive heart failure.

BACKGROUND: Little attention has been given to the resiliency process of family caregivers for older people hospitalized with congestive heart failure. AIMS: The purpose of this study was to examine the influences of older peoples' activities of daily living dependency, family caregivers' spiritual well-being, quality of relationship, family support, coping and care continuity on the burden of family caregivers of hospitalized older people with congestive heart failure using the Resiliency Model of Family Stress, Adjustment, and Adaptation. DESIGN AND SAMPLE. A descriptive, correlational research design was used. There were 50 family caregivers and 50 older people diagnosed with congestive heart failure recruited from medical and surgical units of two Midwest medical centres. METHODS: Data on activities of daily living dependence of older people, family caregiver burden, spiritual well-being, coping strategies, quality of older people-caregiver relationship and care continuity were collected using structured questionnaires. RESULTS: The findings indicated that there were significant positive associations between patients' activities of daily living dependence and family caregiver burden and between lack of family support and family caregiver burden. There were significant negative associations between quality of relationship and family caregiver burden, between care continuity and family caregiver burden, between coping and family caregiver burden and between spiritual well-being and burden. In hierarchical multiple regression, the model variables accounted for 66% of the variance in family caregiver burden. Patients' activities of daily living dependence, quality of relationship and lack of family support are significant predictors of family caregiver burden. CONCLUSIONS: The best predictors of family caregiver burden, using the resiliency model, were the older persons' activities of daily living dependence, family support, quality of relationship, care continuity, coping strategies and spiritual well-being. Implications for practice. It is vital for nurses to assess family caregivers' needs and resources and the quality of the older person-family caregiver relationship in developing a plan of care that reduces family caregiver burden.

Influences of spiritual well-being and coping on mental health of family caregivers for elders.

The purpose of the study was to describe spiritual well-being of family caregivers of elders with congestive heart failure and examine the relationships among family caregivers' spiritual well-being, coping, and mental health. A descriptive, correlational research design was used, and data were collected from a convenience sample of 50 family caregivers. The findings indicated that positive spiritual well-being was inversely related to negative mental health. Examination of the spiritual well-being subscales suggested that faith/belief systems and life satisfaction contributed to the significant correlation. Positive coping strategies were inversely related to negative mental health. Examination of the coping subscales suggested that scores on Problem Solving and Coping, Alternative Perception of Events, and Dealing with Stress Symptoms contributed to the significant correlation with mental health scores. It is vital to identify processes that contribute to family caregivers' mental health to support them in their role.

Influences of Psychological Well-being, Quality of Caregiver-patient Relationship, and Family Support on the Health of Family Caregivers for Cancer Patients in Taiwan.

PURPOSE: The purpose of this study was to examine the influences of psychological well-being, quality of caregiver-patient relationship, and family support on the health of family caregivers for cancer patients in a Taiwanese hospital. METHODS: A cross-sectional, correlational design was used. A sample of 91 family caregivers of hospitalized cancer patients completed the Caregiver Reaction Assessment and Psychological Well-Being Scale. Pearson's product moment correlation and regression analyses were used to examine the data. RESULTS: The psychological well-being and the quality of the caregiver-patient relationship of family caregivers were found to be significantly positively correlated with caregivers' health. The lack of family support was found to be significantly negatively correlated with caregivers' health. Psychological well-being, quality of caregiver-patient relationship, and family support accounted for 59% of the variance in caregivers' health. CONCLUSION: The findings suggest that nurses, while providing care in the hospital and upon discharge need to be aware of the psychological well-being, quality of caregiver-patient relationship, and family support of a family caregiver, as these factors all have an impact on a family caregiver' health.