Tools for assessing nurses’ stigmatizingattitudes toward individuals with mentalillness

Authors

  • Kornélie Kantorová University of Ostrava, Faculty of Medicine, Institute of Nursing and Midwifery, Czech Republic Author https://orcid.org/0009-0000-7016-8149
  • Martina Tomagová Department of Nursing, Jessenius Faculty of Medicine in Martin of the Comenius University in Bratislava, Slovak Republic Author https://orcid.org/0000-0003-2664-8668
  • Aleš Vrána Scioškola Žizkov - Secondary school, s.r.o., Prague, Czech Republic Author

DOI:

https://doi.org/10.12923/pielxxiw-2025-0031

Keywords:

stigma, nurses, mental ill

Abstract

TOOLS FOR ASSESSING NURSES’ STIGMATIZING ATTITUDES TOWARD INDIVIDUALS WITH MENTAL ILLNESS

Aim. To provide an overview of valid and reliable tools  designed to measure  nurses’ stigmatising attitudes toward individuals with mental illness, and to compare these tools based on their psychometric properties and applicability in clinical nursing practice.

Material and methods. Licensed databases were utilised, including MEDLINE (PubMed), Scopus, and EBSCO databases (2000-2023). Relevant studies retrieved from the three databases were included in the narrative review. Data evaluation followed the PRISMA checklist.

Results. A total of 171 studies focused on measuring nurses’ stigmatising attitudes toward individuals with mental illness were identified. Based on selection criteria, 12 studies were included in the final analysis. The following tools were used to assess the level of stigmatisation: Community Attitudes towards the Mentally Ill, Opening Minds Scale for Healthcare Providers, Perceived Professional Stigma Scale, Attribution Questionnaire, Attitudes Towards Acute Mental Health Scale, Recovery Attitudes Questionnaire, and Opinions about Mental Illness.

Conclusions. The selected tools demonstrated acceptable psychometric properties, including reliability and validity, confirming their usefulness for assessing stigmatisation among healthcare professionals, particularly nurses. However, their application in different sociocultural contexts requires further validation and reliability testing on representative samples of respondents within those settings.

References

1. VandenBos GR. (Ed.). APA dictionary of psychology (2nd ed.). Washington: American Psychological Association; 2015. https://doi.org/10.1037/14646-000

2. Corrigan P. How stigma interferes with mental health care. Am. Psychol. 2004;59(7):614-625. https://psycnet.apa.org/doi/10.1037/0003-066X.59.7.614

3. Rao H, Mahadevappa H, Pillay P, et al. A study of stigmatized attitudes towards people with mental health problems among health professionals. J. Psychiatr. Ment. Health Nurs. 2009;16(3):279-284. https://doi.org/10.1111/j.1365-2850.2008.01369.x

4. Bates L, Stickley T. Confronting Goffman: how can mental health nurses effectively challenge stigma? A critical review of the literature. J. Psychiatr. Ment. Health Nurs. 2013;20(7):569-575. https://doi.org/10.1111/j.1365-2850.2012.01957.x

5. Copeland D. Stigmatization in nursing: Theoretical pathways and implications. Nurs. Inq. 2022; 29(2):e12438. https://doi.org/10.1111/nin.12438

6. International Council of Nurses. The ICN Code of Ethics for Nurses. Revised 2021. Geneva: International Council of Nurses; 2021. ISBN: 978-92-95099-94-4.

7. Seeman N, Tang S, Brown AD, et al. World survey of mental illness stigma. J. Affect Disord. 2016;190:115-121. https://doi.org/10.1016/j.jad.2015.10.011

8. Xu X, Li XM, Zhang J, et al. Mental Health-Related Stigma in China. Issues Ment. Health Nurs. 2018;39(2):126-134. https://doi.org/10.1080/01612840.2017.1368749

9. Hansson L, Jormfeldt H, Svedberg P, et al. Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness? International Journal of Social Psychiatry. 2013;59(1):48-54. https://doi.org/10.1177/0020764011423176

10. Glozier N, Hough C, Henderson M, et al. Attitudes of nursing staff towards co-workers returning from psychiatric and physical illnesses. Int. J. Soc. Psychiatry. 2006;52(6):525-34. https://doi.org/10.1177/0020764006066843

11. Modgill G, Patten SB, Knaak S, et al. Opening Minds Stigma Scale for Health Care Providers (OMS-HC): examination of psychometric properties and responsiveness. BMC Psychiatry. 2014;14(1):120. https://doi.org/10.1186/1471-244X-14-120

12. Page, et al. ‘PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. 2024; 372: n160. https://doi.org/10.1136/bmj.n160

13. Del Olmo-Romero F, González-Blanco M, Sarró S, et al. Mental health professionals’ attitudes towards mental illness: professional and cultural factors in the INTER NOS study. Eur. Arch. Psychiatry Clin. Neurosci. 2019; 269(3):325-339. https://doi.org/10.1007/s00406-018-0867-5

14. Al-Awadhi A, Atawneh F, Alalyan MZY, et al. Nurses’ Attitude Towards Patients with Mental Illness in a General Hospital in Kuwait. Saudi J. Med. Sci. 2017;5(1):31-37. https://doi.org/10.4103/1658-631X.194249

15. Chambers M, Guise V, Välimäki M, et al. Nurses’ attitudes to mental illness: a comparison of a sample of nurses from five European countries. Int. J. Nurs. Stud. 2010;47(3):350-362. https://doi.org/10.1016/j.ijnurstu.2009.08.008

16. Siqueira SRG, Abelha L, Lovisi GM, et al. Attitudes Towards the Mentally Ill: A Study with Health Workers at a University Hospital in Rio de Janeiro. Psychiatr. Q. 2017;88(1):25-38. https://doi.org/10.1007/s11126-016-9431-5

17. Ubaka CM, Chikezie CM, Amorha KC, et al. Health Professionals’ Stigma towards the Psychiatric Ill in Nigeria. Ethiop. J. Health Sci. 2018;28(4):483-494. https://doi.org/10.4314/ejhs.v28i4.14

18. Cremonini V, Pagnucci N, Giacometti F, et al. Health Care Professionals Attitudes Towards Mental Illness: Observational Study Performed at a Public Health Facility in Northern Italy. Arch. Psychiatr. Nurs. 2018;32(1):24-30. https://doi.org/10.1016/j.apnu.2017.09.007

19. Napoli G, Autuori S, Ephraim KS. Attitudes of Italian mental health nurses towards mental illness and recovery: a cross-sectional study. AIMS Public Health. 2023;10(2):333-347. https://doi.org/10.3934/publichealth.2023025

20. Ng YP, Rashid A, O’Brien F. Determining the effectiveness of a video-based contact intervention in improving attitudes of Penang primary care nurses towards people with mental illness. PLoS One. 2017;12(11):e0187861. https://doi.org/10.1371/journal.pone.0187861

21. Kolb K, Liu J, Jackman K. Stigma towards patients with mental illness: An online survey of United States nurses. Int. J. Ment. Health Nurs. 2023;32(1):323-336. https://doi.org/10.1111/inm.13084

22. Arvaniti A, Samakouri M, Kalamara E, et al. Health service staff’s attitudes towards patients with mental illness. Soc. Psychiatr. Epidemiol. 2009;44(8):658-665. https://doi.org/10.1007/s00127-008-0481-3

23. Munro S, Baker JA. Surveying the attitudes of acute mental health nurses. J. Psychiatr. Ment. Health Nurs. 2007;14(2):196-202. https://doi.org/10.1111/j.1365-2850.2007.01063.x

24. Fontesse S, Rimez X, Maurage P. Stigmatization and dehumanization perceptions towards psychiatric patients among nurses: A path-analysis approach. Arch. Psychiatr. Nurs. 2021;35(2):153-161. https://doi.org/10.1016/j.apnu.2020.12.005

25. Evans-Lacko S, Little K, Meltzer H, et al. Development and psychometric properties of the Mental Health Knowledge Schedule. Can. J. Psychiatry. 2010;55(7):440-448. https://doi.org/10.1177/070674371005500707

26. Haslam N. Dehumanization: an integrative review. personality and social. Psychology Review. 2006;10(3), 252-264. https://doi.org/10.1207/s15327957pspr1003_4

27. Cohen J, Struening EL. Opinions about mental illness in the personnel of two large mental hospitals. J. Abnorm. Soc. Psychol. 1962;64:349-360. https://doi.org/10.1037/h0045526

28. Corrigan P, Markowitz FE, Watson A, et al. An attribution model of public discrimination towards persons with mental illness. J. Health Soc. Behav. 2003;44(2):162-179.

29. Taylor SM, Dear MJ. Scaling community attitudes toward the mentally ill. Schizophr. Bull. 1981;7:225-240. https://doi.org/10.1093/schbul/7.2.225

30. Sanabria-Mazo JP, Doval E, Bernadàs A, et al. Over 40 years (1981-2023) assessing stigma with the Community Attitudes to Mental Illness (CAMI) scale: a systematic review of its psychometric properties. Syst. Rev. 2023;12(1):66. https://doi.org/10.1186/s13643-023-02230-4

31. Corrigan PW. Mental health stigma as social attribution: implications for research methods and attitude change. Clin. Psychol. Sci. Pract. 2000;7(1):48-67. https://doi.org/10.1093/clipsy.7.1.48

32. Pingani L, Forghieri M, Ferrari S, et al. Stigma and discrimination toward mental illness: translation and validation of the Italian version of the Attribution Questionnaire-27 (AQ-27-I). Soc. Psychiatr. Epidemiol. 2012;47(6):993-999. https://doi.org/10.1007/s00127-011-0407-3

33. Sousa S de, Marques A, Rosário C, et al. Stigmatizing attitudes in relatives of people with schizophrenia: a study using the Attribution Questionnaire AQ-27. Trends Psychiatry Psychother. 2012;34:186-197. https://doi.org/10.1590/S2237-60892012000400004

34. Muñoz M, Pérez Santos E, Crespo M, et al. Estigma y enfermedad mental: análisis del rechazo social que sufren las personas con enfermedad mental. Madrid: Editorial Complutense, 2009.

35. Borkin JR, Steffen JJ, Ensfield LB, et al. Recovery attitudes questionnaire: Development and evaluation. Psychiatr. Rehabil. J. 2000;24(2):95-102. https://doi.org/10.1037/h0095112

36. Corrigan PW, Edwards AB, Green A, et al. Prejudice, social distance, and familiarity with mental illness. Schizophr. Bull. 2001;27(2):219-225. https://doi.org/10.1093/oxfordjournals.schbul.a006868

37. Martínez-Martínez C, Sánchez-Martínez V, Sales-Orts R, et al. Effectiveness of direct contact intervention with people with mental illness to reduce stigma in nursing students. Int. J. Mental Health Nurs. 2019;28(3):735-743. https://doi.org/10.1111/inm.12578

38. Valery KM, Prouteau A. Schizophrenia stigma in mental health professionals and associated factors: A systematic review. Psychiatry Research. 2020;290:113068. https://doi.org/10.1016/j.psychres.2020.113068

39. Hsiao CY, Lu HL, Tsai YF. Factors influencing mental health nurses’ attitudes towards people with mental illness. Int. J. Ment. Health Nurs. 2015;24(3):272-280. https://doi.org/10.1111/inm.12129

40. Fridberg DJ, Ahmed AO. Critical synthesis package: Attribution questionnaire-short form (AQ-27) MedEdPORTAL. 2013;9:1-8. https://doi.org/10.15766/mep_2374-8265.9532

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Published

2025-10-06

How to Cite

Kantorová, K., Tomagová, M., & Vrána, A. . (2025). Tools for assessing nurses’ stigmatizingattitudes toward individuals with mentalillness. Nursing in the 21st Century, 24(3(92), 258-264. https://doi.org/10.12923/pielxxiw-2025-0031