Mental health nurses' measured attitudes to people and practice: systematic review of UK empirical research 2000–2019

Geoffrey L. Dickens, Mariyana Schoultz, Nutmeg Hallett

Research output: Contribution to journalLiterature reviewpeer-review

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4.1 Introduction: Attitudes are considered integral to mental health nursing practice.

4.2 Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice.

4.3 Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK-based mental health nurses' attitudes with multi-item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes.

4.4 Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude-practice links.

4.5 Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice.

4.6 Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co-morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude-practice links.
Original languageEnglish
JournalJournal of Psychiatric and Mental Health Nursing
Early online date11 Feb 2022
Publication statusE-pub ahead of print - 11 Feb 2022


  • mental health
  • personality disorders
  • psychiatric nursing attitude
  • psychometrics
  • systematic review
  • violence


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