Is the Community Attitudes towards the Mentally Ill scale valid for use in the investigation of European nurses' attitudes towards the mentally ill? A confirmatory factor analytic approach.

AIM: This study aimed to assess the construct validity of the Community Attitudes towards the Mentally Ill scale in the investigation of European nurses' attitudes towards mental illness and mental health patients. BACKGROUND: The harbouring of negative attitudes by nurses towards any patient can have implications for recovery. To gather robust evidence upon which to base information and education aimed at fostering acceptance, support and general positivity towards people with mental health illness, a valid and reliable system of data collection is required. METHOD: A confirmatory factor analysis of both the original Community Attitudes towards the Mentally Ill scale and two modified versions of the scale were carried out during May - June 2007 using a data set representing the responses of 858 European nurses to the scale. Data were subjected to three different confirmatory factor analyses using Maximum Likelihood estimation in the software package, Analysis of Moment Structures 7. A number of absolute, relative and incremental fit statistics were used to assess the fit of the original Community Attitudes towards the Mentally Ill scale and two modified versions to the European nursing data. FINDINGS: A modification of the scale was found to be most suitable for use in the investigation of European nurses' attitudes towards mental illness and people with mental illness. CONCLUSION: Further research is recommended to develop a valid and reliable research tool to specifically measure the attitudes of 'nurses' working across different mental healthcare facilities towards this vulnerable patient group.

Psychosocial care in mental health nursing: a think aloud study.

AIM: This paper is a report of a study identifying psychosocial interventions relevant to routine care and exploring their content critically and analysing patterns in the use of these interventions. BACKGROUND: People experiencing enduring and serious mental disorders value psychosocial engagement as a means of achieving recovery and rehabilitation. However, mental health nurses' use of person-centred and directive psychosocial engagement in routine care is unclear, with the potential arising for benevolence and paternalism. METHOD: A think aloud study was carried out with 37 mental health nurses responding to a simulated case depicting a person with an enduring mental health problem. Participants were recruited from community and acute hospital facilities across Ireland and responded to two tasks: identifying the nature of the person's problems and recommending what to do next. Transcripts were coded using judgement and intervention themes designed for the purpose. Patterns in the use of psychosocial intervention themes were described and further analysed by level of experience (highly experienced or not) and practice setting (acute/community setting). FINDINGS: A task-oriented psychosocial intervention labelled structured engagement was used extensively, followed by reassurance and encouragement based on pragmatic communication. A minority of nurses used dialogue, representing person-centred care. Highly experienced community mental health nurses were the most likely to talk in terms of intensive psychosocial engagement. CONCLUSION: Relying on pragmatic problem-solving is problematic in terms of decision-making transparency and service user involvement. The use of informal knowledge in practice should be negotiated through more open discussion by nurses, including adoption of a consensus on the components of psychosocial care.

Developing a data dictionary for the irish nursing minimum dataset.

One of the challenges in health care in Ireland is the relatively slow acceptance of standardised clinical information systems. Yet the national Irish health reform programme indicates that an Electronic Health Care Record (EHCR) will be implemented on a phased basis. [3-5]. While nursing has a key role in ensuring the quality and comparability of health information, the so- called 'invisibility' of some nursing activities makes this a challenging aim to achieve [3-5]. Any integrated health care system requires the adoption of uniform standards for electronic data exchange [1-2]. One of the pre-requisites for uniform standards is the composition of a data dictionary. Inadequate definition of data elements in a particular dataset hinders the development of an integrated data depository or electronic health care record (EHCR). This paper outlines how work on the data dictionary for the Irish Nursing Minimum Dataset (INMDS) has addressed this issue. Data set elements were devised on the basis of a large scale empirical research programme. ISO 18104, the reference terminology for nursing [6], was used to cross-map the data set elements with semantic domains, categories and links and data set items were dissected.