Judging the other: psychiatric nurses’ attitudes towards identified inpatients as measured by the semantic differential technique

Abstract

Nurses' attitudes towards psychiatric patients can be expressed in terms of either a symptom-oriented approach or a personhood-focused approach where the latter is characterized by the ambition to establish a genuine and lasting relationship, while the former places the emphasis on correcting 'defective' patient behaviour. To study whether previous typologies found in a qualitative in-depth interview study exist in a larger quantitative investigation and, if so, to identify and describe a structure for the nurses' attitudes connected to each of the identified typologies. Six psychiatric group dwellings and six acute psychiatric hospital wards participated in the study. In all, 2700 assessments of 163 patients were sent out to 160 respondents and 2436 answers were returned, that is, the external dropout rate was 9.8%. The semantic differential technique was used. This is a method for quantifying the meaning that is attached to an identified phenomenon through series of bipolar pairs of adjectives. The scale has 57 bipolar pairs of adjectives, which estimates an unknown number of dimensions of nurses' attitudes towards an identified patient. The respondents' answers were analysed through entropy-based measures of association combined with structural plots. The analysis revealed that the four typologies existed as a delimited group, especially the groups of 'good' and 'evil' patients, while the 'crazy' and 'invisible' patients existed in a more blurred form. The analysis also revealed that the two groups, 'good' and 'evil', were connected to the nurses' ethical and aesthetic attitude structure, while the 'crazy' patients were linked to the cognitive structure and the 'invisible' patients to the empathetic structure. The study indicates that the two typologies, 'good' and 'evil', could be seen as each other's antithesis and, together with the other two typologies, 'crazy' and 'invisible', they touched upon a structure of the nurses' attitudes that was closely connected to a negative view of the patient except in one case -'the good' patients, which was probably based on his/her exterior symptoms.