Abstract
A number of studies have identified that doctors and nurses had negative attitudes towardshospitalised patients who have attempted suicide, and there some evidence that these attitudeshave a negative impact upon the quality of patients' care as well as in the prevention of patients'future attempt to suicide. The present study used a cross-sectional research design to explore the attitudes of doctors', and nurses' working in Greek general hospitals, towards hospitalised patients who have attempted suicide. Data were collected using a likert type scale assessing attitudes towards attempted suicide patients. The scale was developed by the researcher, based on an instrument developed by Domino et al. (1982) and on concepts emerging from the literature review. In order to establish the scale's construct validity a factor analysis was performed in 186 (n=186) respondents and the following 8 factors emerged: positiveness, acceptance, religiosity, care, manipulation, personality, mental illn ...
A number of studies have identified that doctors and nurses had negative attitudes towardshospitalised patients who have attempted suicide, and there some evidence that these attitudeshave a negative impact upon the quality of patients' care as well as in the prevention of patients'future attempt to suicide. The present study used a cross-sectional research design to explore the attitudes of doctors', and nurses' working in Greek general hospitals, towards hospitalised patients who have attempted suicide. Data were collected using a likert type scale assessing attitudes towards attempted suicide patients. The scale was developed by the researcher, based on an instrument developed by Domino et al. (1982) and on concepts emerging from the literature review. In order to establish the scale's construct validity a factor analysis was performed in 186 (n=186) respondents and the following 8 factors emerged: positiveness, acceptance, religiosity, care, manipulation, personality, mental illness and discrimination. The 8 factors yielded accounted for the 55.45% of the total variance. Test-retest assessment of the instrument reliability revealed Crombach's alpha a=0.97 (test) and r=0.99 (retest) respectively, which supported the high internal consistency of the scale. The study was carried out in 19 public hospitals across Greece. Questionnaires were distributed to all nurses and doctors working in medical, surgical, orthopaedic, psychiatric wards as well as in intensive care units and accident and emergency departments. A sample size of 1042 (n=1042) doctors and nurses was obtained giving a response rate of 66.3%. The statistical analysis showed that respondents held relatively negative attitudes towards attempted suicide patients. There were intercorrelations within the 8 factors yielded from the factor analysis of the scale measuring attitudes towards patients who had attempted suicide. Thus, respondents who had a more favourable attitude towards patients who had attempted suicide: - Displayed more acceptance for patients' act to attempt to suicide - Their religious beliefs did not influence so much their attitudes towards suicide attempts - Held the view that hospitalised care of attempted suicide patients' was poor - Did not hold such strong opinions that attempted suicide was a form of manipulative patient behaviour - Expressed less negative believes with regard to the personality of patients who had attempted suicide - Were less likely to view patients who had attempted suicide as mentally ill - Held less discriminative beliefs about patients who attempted suicide. Respondents described that they experienced a variety of feelings in response to the hospitalisation of attempted suicide patients. Such feelings were sadness (19.7%), understanding (17.4%), frustration (14.2%), sympathy (11.9%), responsibility (10%), discontent (8.2%), embarrassment (5.3%), irritability (4%), anger (2.6%), discomfort (2%) and fear (1.1%). One-way analysis of variance (ANOVA) of all the independent variables on the scale assessing attitudes towards attempted suicide patients showed that age as an independent variable was not significantly (p=0.651) influential on respondents’ attitudes towards patients who had attempted suicide. In contrast to the above finding, respondent's age and years of experience in a hospital setting showed statistically significant (p=0.001) influence on attitudes. In particular, respondents who were younger and had less working experience held more positive attitudes compared to older and more experienced nurses and doctors. In general doctors held more positive attitudes compared to nurses. An exception was found in the attitudes of doctors working in intensive care units, these doctors had more negative attitudes compared to nurses in that department. Residents held more positive attitudes compared to consultants and medical directors. However, medical directors displayed more favourable attitudes to that group of patients in comparison with consultants' attitudes. Statistical significant differences were also found between the attitudes of registered and assistant nurses, with the former holding more positive attitudes towards patients who had attempted suicide. Respondents working in surgical and orthopaedic wards had more favourable attitudes compared to other units. The most negative attitudes were expressed by respondents in intensive care units, then in accident and emergency departments, then in medical wards, and then in psychiatric wards. Psychiatrists displayed more favourable attitude compared to mental health nurses. Nursing specialisation title and postgraduate studies were found to have positive influence on respondents' attitudes. Nevertheless, postgraduate studies were found to have more influence on respondents' attitudes. In addition, other factors were found to influence doctors and nurses' attitudes. Especially, respondents' previous personal thoughts about attempting suicide, a previous personal suicide attempt, and the level of relationship with a person who had committed suicide were shown to create more positive attitudes to patients who had attempted suicide. Hospitals' geographical location (urban or semi-urban) has not found to have influence on doctors' and nurses' attitudes towards attempted suicide patients. From the multiple regression analysis showed that nursing specialisation title, postgraduate studies and a younger age were the predictors for a more positive attitudes towards patients who had attempted suicide patients.
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