Trait Mindfulness, Compassion, and Stigma Towards Patients with Mental Illness: A Study Among Nurses in Sri Lanka

Abstract

Objectives Stigma towards persons with mental illness is widespread. Mindfulness may protect against stigma by cultivating accepting attitudes, non-reactivity, and prosocial emotions. This study aimed to assess whether higher trait mindfulness among nurses was linked to lower stigma towards psychiatric patients, and whether compassion mediated this relationship. Method In this cross-sectional study among nurses in four tertiary care hospitals in Sri Lanka, stigma towards psychiatric patients was assessed using the Attribution Questionnaire (AQ-9), which assesses nine separate domains of stigma. The 20-item Six-Facet Mindfulness Questionnaire and the 5-item Santa Clara Brief Compassion Scale were used to assess mindfulness and compassion, respectively. Correlations among these variables were explored. Mediation analyses were performed. Results A total of 405 nurses (90.6% female, mean age = 39.6 years) participated in the study. Those with higher trait mindfulness were more likely to believe they would help a person with mental illness, and less likely to believe a person with mental illness should be avoided or segregated from the society. Compassion was inversely correlated with avoidance and anger, and positively correlated with pity, helping, and coercion domains. Trait mindfulness was positively correlated with compassion. Mediation models revealed that compassion partially mediated the effects of trait mindfulness on helping and avoidance. Facet-level analyses revealed significant effects of describing, non-reactivity, and observing on several stigma domains mediated through compassion. Conclusions Trait mindfulness among nurses appears to have a direct buffering effect against several domains of stigma towards psychiatric patients and significant indirect effects through compassion, albeit with small effect sizes. Preregistration This study is not pre-registered.

Stigma on Mental Illness among Nurses

“…Participants with a high level of knowledge were reported to be more likely to help patients with mental illness than those with a moderate level of knowledge. This positive correlation between knowledge and helping behaviour aligns with similar findings in studies conducted by Kigozi-Male et al (2023) and Baminiwatta et al (2023). The more education, years of experience, and patient contact that healthcare professionals have, the more positive their attitude toward mental illness will be (Ghuloum et al, 2022).…”

“…This could involve interventions that are more assertive or coercive. There has long been debate concerning the morality of coercive treatment in mental health care (Baminiwatta et al, 2023). More compassionate nurses likely thought that the patient would benefit from treatment against their will because the patient's mental illness may have caused them to lose comprehension.…”

“…According to earlier research, coercive therapy is often used with psychiatric patients because medical professionals view it as morally acceptable. This phenomenon is referred to as "good coercion" or "beneficial coercion" (Baminiwatta et al, 2023). Pity, which measured nurses' feelings of sympathy, compassion, and empathy for those suffering from mental illnesses, had the next-highest score is supported by some studies identified this stereotype as the most frequently recognized stigma (Ihalainen-Tamlander et al, 2016).…”