Therapeutic commitment and care of persons with mental illness: a survey of nurse practitioners' role perceptions

  • Author / Creator
    Creamer, Anne Marie
  • This study explored Canadian nurse practitioners’ (NPs) levels of therapeutic commitment (TC), role competency (RC) and role support (RS) when caring for persons with mental illness and mental health problems. Knowledge and experiential factors that impact these levels were examined and a model of therapeutic commitment was tested. A self-administered mail survey was sent to 1272 NPs from all Canadian jurisdictions except the Yukon, Saskatchewan and Quebec. The survey was comprised of the Mental Health Problem Perceptions Questionnaire (MHPPQ), demographic data and open-ended questions. Using Dillman’s Tailored Design Method, the target population was contacted 4 times: pre-notice letter, first survey, reminder letter, and repeat survey. Of the 1272 potential participants, 680 (57.2%) useable surveys were received. Out of a possible maximum score of 7, NPs reported mean levels of 5.05 (SD 0.83) on the TC, 5.02 (SD 0.88) on the RC and 4.86 (SD 1.27) on the RS subscales. As hypothesized, correlations between the three subscales were demonstrated with RC and TC being the most strongly associated (r = .754, p <.001). A composite variable, Confidence to Manage, which examined NPs’ confidence to manage 7 mental health disorders and suicide ideation was developed. Scores for this variable correlated with TC, RC and RS scores. Feeling ill-equipped to work with this population, knowledge of community mental health services, ratings of relevant theoretical and clinical NP education, previous mental health and NP work experience were all positively correlated with higher levels of the 4 subscales. Differences in categories for population size of the community the NP worked in, frequency of collaboration for psychiatric reasons, time since the NP accessed mental health education and highest level of nursing education were found to impact levels of TC, RS, RC and Confidence to Manage. A large number of NPs reported feeling inadequately prepared to manage the care of persons with mental illness and recommended either adding or increasing mental health education in their NP programs. Most NPs saw the care of this population as part of their role and acknowledged the need for increased support for persons with mental health issues.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Doctor of Philosophy
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  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
  • Supervisor / co-supervisor and their department(s)
  • Examining committee members and their departments
    • Hunter, Kathleen (Nursing)
    • Northcott, Herb (Sociology)
    • Boschma, Geertje (Nursing)
    • O'Brien, Beverley (Nursing)