An Investigation of Nursing Staff Attitudes and Emotional Reactions Towards Patients with Intellectual Disability in a General Hospital Setting

This study explores the application of Weiner's cognitive-emotional model of helping behaviour to care staff responses to challenging behaviour of people with learning disabilities. Participants were 20 residential care staff who worked with people with challenging behaviour and 20 who did not. Six examples of challenging behaviour were presented, and for each behaviour participants were asked to give a probable cause, rate attributions of stability, internality, globality and controllability for their cause, their optimism for change of the behaviour, their evaluation of the behaviour and a person showing the behaviour, their emotional response to the behaviour and their willingness to put extra effort in to helping change the behaviour. Data were analysed using correlation and regression methods. Carers working with people with challenging behaviour were more likely to evaluate the person more positively and report they would be more likely to offer extra effort in helping. A path analysis showed that helping behaviour was best predicted by optimism, which was best predicted by negative emotion which was best predicted by the attribution of controllability. We conclude that attributions and emotions reported by carers in response to challenging behaviour are consistent with Weiner's cognitive-emotional model of helping behaviour. Formulating carer behaviour using such models offers the possibility of using cognitive-behavioural methods in working with staff beliefs, emotions and behaviour in response to challenging behaviour.

To measure the emotional reactions and expectations of 64 nurses in a general hospital to vignettes describing patients with unstable diabetes and a co-morbid psychiatric diagnosis. A small scale questionnaire survey was used in a within-groups design. Findings suggest that the nurses in the sample were fearful of people with a mental health problem. They were wary of possible unpredictable behaviour. Qualified staff generally felt better equipped to cope with such patients, depending on their psychiatric experience. General/adult nurses who have had more exposure to patients with mental health problems during their initial training are more likely to feel adequately prepared for managing people with mental health problems.