Clarifying the Strengths-Oriented Attitude among Nurses in Psychiatric Hospitals in Japan

Abstract

Japanese psychiatric mental health systems are being steadily improved. Psychiatric nurses' attitude towards strengths of persons with mental disability is critical in order to promote de-institutionalization of patients. However, nurses' attitudes, particularly their Strengths-Oriented Attitude (SOA) has not been well studied and explained. The purpose of this study was to clarify the SOA of nurses working in psychiatric hospitals in Japan. There were 1148 Psychiatric Registered Nurses (PRN) and Psychiatric Practical Nurses (PPN) employed at 17 psychiatric hospitals in Japan who consented to participate in the study. The self-administered questionnaire was mailed and returned between October 2013 and January 2014. The subjects' SOA was evaluated using the Strengths-Oriented Attitude Inventory (SOAI) developed by the authors based on the work by Rapp and Goscha. The actual SOA and its relationship to individual characteristics were also analyzed to clarify the SOAI. Factor analysis revealed four components of the SOAI: Factor 1 = "Nursing practice based on the assessment which focused on social resources"; Factor 2 = "Nursing practice based on the holistic assessment of person with mental disability"; Factor 3 = "Support in community which respected the person's way of living"; and Factor 4 = "Emphasize of the strengths of individual with mental disability." Results indicated a high orientation toward Factors 2 and 4, but a low orientation toward Factors 1 and 3. There were no significant differences between age, years of psychiatric nursing experience, academic background, and subjects' SOA. However, differences were observed in gender, current workplace, work position, type of license, and work experience. The subjects showed low orientation toward social resources and respected the patient's way of life. Nurses working in psychiatric mental health institutions should receive continuing education courses designed to increase their orientation toward Factors 1 and 3. * Corresponding author. M. Kataoka et al.777

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS<sup>©</sup>)

“…These were evaluated as important. In a study by Kataoka et al [28], Japanese nurses' involvement in patient situations included four factors based on the assessment which focused on social resources; holistic assessment, person's way of living, and the strengths of individuals with mental disability. It is considered that, in order to understand patients [29] responses to care involving appreciation of human wholeness occur in a momentary resolution often from their viewpoints on nursing care, and thoughts of the patient as an "important" factor.…”

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

“…In there, nurses must provide care with an emphasis on social resources and respect for the patient's way of living through interdisciplinary cooperation [17] [18]. The patient's thoughts and family involvement is important as was suggested in the study results [10] [19].…”