Reducing Nursing Stigma of Patients Diagnosed with Psychiatric Illnesses on a Medical-Surgical Inpatient Unit

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  • March 20, 2019
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  • Danielson, Brittany
    • Affiliation: School of Nursing
Abstract
  • Background: Individuals diagnosed with psychiatric illnesses are frequently hospitalized in non-psychiatric settings for either medical illnesses, surgery, and/or for symptom exacerbation. The nurses who care for those patients often do not have adequate education and training to provide clinically competent and culturally sensitive psychiatric-mental health nursing care. Purpose: The purpose of this project was to: (a) increase medical-surgical nurses’ and nursing assistant’s understanding of psychiatric illnesses, (b) enhance compassionate care, and (c). decrease the negative attitudes associated with stigma related to patients who have comorbid physical/psychiatric illnesses in the inpatient medical-surgical setting. Methods: This Quality Improvement Project followed a step-by-step process (PDSA) to identify the learning needs of nursing staff and the potential for negative attitudes and stigmatizing behaviors on an inpatient medical-surgical unit in a community hospital. The administration of a learning needs assessment initiated the QI process and the 4-week interactive educational-training program that incorporated evidence-based stigma reduction modalities and education tailored to the setting’s patient population. The nursing staff’s attitudes were measured as a group pre- and post-program completion using the Mental Illness: Clinicians’ Attitudes, Version Four Scale (MICA v4). A post-survey was administered to assess the nursing staff’s perception of compassion and understanding after program completion. Results: Overall, the QI project was successfully implemented and focused on patient-centered nursing care. The post-program evaluation indicated that the project promoted nursing staff to have a better understanding of psychiatric illnesses, while also enhancing their ability to provide compassionate nursing care. The MICA v4 scores (using aggregate data) decreased from 38.8 to 33.8, indicating an improved attitude (and decreased stigma) towards patients with psychiatric illnesses. An unpaired t-test resulted in a p-level of 0.00067 indicating a potential correlational relationship between the education/training program and attitudinal change. Conclusion/Implications: The project was able to meet and exceed its three main purposes, with the potential of replicating this program hospital-wide. Limitations included low attendance, use of a low strength statistical correlational test, and use of a stigma tool that requires further research. Future programs should track individual stigma scores, measure behavioral outcomes, and use a stigma survey that has been widely used. KEYWORDS: Stigma, medical-surgical nursing, psychiatric illnesses, quality improvement, attitudes, compassionate care
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  • In Copyright
Advisor
  • Soltis-Jarrett, Victoria
  • Aucoin, Julia
  • Piven, Mary Lynn
Degree
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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