| Summary: | Methods: Study one; cross sectional survey of all acute mental health nurses working at 10 MHS Trusts (n=2130). The survey contained a validated attitude scale (ATAMH) and questions exploring a range of personal, professional and organisational variables. Study two; semi-structured interviews with acute mental health nurses and service users with experience of acute inpatient care. Results: Study One: The mean total attitude score was 172 which is positive, the maximum score available is 255. Multiple regression analysis identified seven predictors of attitudes which accounted for 21.3% of the variance in the total attitude score: pay banding; influence of psychosocial approaches; influence of involving service users; experience of working in the community; education at post graduate/higher degree level; being up to date on policy, research and practice relevant to acute mental health care; having personal and family experience of mental health problems. Study Two: 16 nursing staff from two units covering a range of pay bands and length of experience were interviewed. Ten service users with a range of acute inpatient experience were interviewed. Three overarching themes were identified: 1) Pre-determined factors influencing attitudes such as personality, reasons for doing the job, personal and family experiences of mental health problems 2) Wider contextual factors such as clinical leadership, patient stereotypes, ward culture and team values 3) Outcomes of nursing practice and the service users experience of care. Nurses who had positive attitudes made patients feel valued. Nurses with negative attitudes made patients feel like they were a pain and not deserving of care. Service users believed pre-determined factors had the greatest impact on nurses' attitudes. Nursing staff placed greater emphasis on the influence of contextual factors and underestimated the impact of attitudes on service users' experience.
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