الفهرس 
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Abstract
P
eople with mental illness are common across the world, with 14% of the global burden of disease. It has been estimated that at least 58 per 1 000 people have a mental illness and about 10 million Indians suffer from severe mental illness.
On the other hand, people with mental illness are among the most stigmatized and vulnerable groups of patients in the healthcare setting.
Mental health nurses are an integral component of a multidisciplinary mental healthcare team. They play a critical role in psychiatric treatment and safeguarding the human rights of persons with mental illness both in the hospital and in the community.
Undergraduate nursing programs provide opportunities to influence nursing students’ attitudes toward people with mental illness through theoretical preparation and appropriate clinical exposure in mental health nursing. Literature suggests that nursing students hold stigmatizing attitudes toward people with mental illness.
That majority of students hold positive attitude towards people with mental illness and satisfied with their preparation in mental health nursing.
Research has clearly demonstrated the positive influence of various teaching strategies such as problem based learning, preclinical undergraduate workshops, role-plays, clinical experiences with preceptors to improve the nursing students’ attitudes toward people with mental illness and mental health nursing.
Studies also highlighted the benefits of clinical experiences to enable the nursing students in improving professional skills and to foster positive attitude towards psychiatric patients.
Aim of the Study:
The aim of this study was to assess nursing students’ attitude toward patients with psychotic disorders.
Research question:
- What is students’ attitude toward patient with psychotic disorders?
Research settings:
This study was conducted at technical institute in Sayed Galal at Al Azhar University which covers all student nurses in technical institute at Al-Azhar University and Ain Shams University.
Subjects of the study:
This study included 286 nursing students from 2 Egyptian nursing institutes. The sample was nearly halved between Saied Galal and Ain shams nursing institutions.
Tools of data collection:
Data were collected using the following tools:
1- Demographic data survey instrument
The demographic form consists of five items to seek the background of the participants in the study that include “age, education, residence, and contact with mental illness.”
2- Attitude scale for mental illness
The study questionnaire used in the current study is the one developed by Balon et al. (1999). Permission to use the questionnaire was obtained from the authors. It is a 29-item questionnaire that assesses attitudes towards psychiatry across six domains. All the items are rated on a Likert scale scored from 1 (strongly disagree) to 4 (strongly agree). This questionnaire has been used in different studies across different countries and has been found to be a reliable and valid instrument.
Pilot study:
The pilot study was conducted on 33 randomly selected nursing students representing the whole study levels. They represent 10% of total sample. Those women were excluded from the actual study sample.
The main findings of this study revealed that:
• An analysis of socio-demographic characteristics showed that: The majority of participants of the current study were female students. 46.7% of the students sample was between 15-19 years old and the remaining % was between 20 to 23 years old. 14.2% of nursing students currently had or have had personal contact with someone with a mental health problem. 14.2% of nursing students had history of family mental illness.
• Based on the median of the total attitude % score, 53.47%of the sample had positive attitude (> the median).
• Significant higher means attitude towards mental patients dimension were among the females, students with nursing secondary school background, students belonging to Saied Galal institute and the students at the higher study levels since p-value<0.01.
• Higher mean of total attitude towards mental patients rights’ dimension was observed as regard the family history of mental relative and the students study level with higher means among those with positive history and the nursing students at higher study levels since p<0.05.
• Bivariate analysis showed that the female gender, students with nursing secondary school background, students belonging to Saied Galal institute and the students at the higher study levels were significant factors for the positive community attitude towards mental patients dimension as they had the higher means.
• Added to the previous significant risk factors, the positive history of dealing with mental patients, psychiatric doctors and previous mental health training were also a highly significant factors towards positive attitude towards the current training at the institutes since p<0.001.
• By classifying the total attitude % into positive (>median score) and negative (≤ median score) attitude, the only significant risk factors for positive attitude were the type of secondary school, type of the nursing institute and the student study level, being higher at nursing secondary school (61.5% vs 42%), at Saied Galal institute (64.4% vs 42.3%) and at the higher study levels.
• In order to select the significant predictors among the three significant risk factors for the student positive attitude, logistic regression analysis was used. The model showed that the study level of the students and the type of institute were only the significant predictors. It was clear that the odds of the positive attitude will decreased if the type of the institute changed from Saied Galal (code=1) to Ain shams (code =2) as the Exponential B was below one, while the odds of the positive attitude will increased if the study level increased by one as the Exponential B was above one.
Conclusion
Based on the result of the current study; it can be concluded that:
• Only half of the study students had positive attitude towards the psychiatric patients.
The present study showed that some student characteristics, such as age, sex, educational level, family history of dealing with psychotic patient, type of institution, nursing secondary schooling prior training and level of study specialty had an effect on knowledge, confidence, attitudes and current practices were grading the recognition, good nursing care and decreasing stigmatization.
In the light of these findings it is recommended that:
• Attempts should be carried out to change the negative attitude of students towards mental illness will affect the quality of the patient care.
• Attitudes are important in determining behaviors, so it is important for the policy makers to focus on nurse’s attitudes; as they are the care providers of mentally ill patients.
• Providing more information and clinical training in the field of psychiatric nursing.
• Providing a variety of community mental health services are essential to improve attitude about psychiatric nursing career and psychiatric patients.
• This study may reflects insufficient knowledge of some students related to psychiatric department, and that educational interventions directed at nursing students should include all the above information on nursing care psychotic patient.
• In the light of increasing pressure on non-psychiatric medical and nursing staff to manage psychotics, these findings should encourage training programs for non-psychiatric medical and nursing staff to include psychosocial training and to disseminate recommended treatment guidelines for psychotics, to increase the effectiveness of managing and professional outcomes.
Further recommended researches:
Finally we recommend repeating this study, its important repeat this study with practicing nurses and nursing students to identify the impact on knowledge, attitudes, and behaviors in clinical practice. Incorporating a qualitative component to further studies may help to further understand participants’ experiences in this learning activity. Further exploration on identifying students with limited baseline exposure to clients with mental illness and assessing how an intentional clinical experience may influence knowledge, attitudes, and behavior is warranted.