Evaluation of a participatory anti-stigma seminar for nurses in training [Evaluation eines partizipativen Anti-Stigma Seminars für Auszubildende in der Pflege]
| ISRCTN | ISRCTN68926489 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN68926489 |
- Submission date
- 30/10/2024
- Registration date
- 13/01/2025
- Last edited
- 02/07/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
In the healthcare system, structural discrimination against people with mental illness is repeatedly evident. They are often not treated or taken seriously because of somatic (body) issues or receive poorer somatic care, resulting in an increased death rate. To counteract this, it is necessary to address stigmatising attitudes of mental health staff. A central group in the medical system are nurses, as they are often in the most direct contact with patients and spend the most time with them. Across studies, it has been shown that nurses' attitudes towards mental illness significantly influence the quality of care and that nurses provide poorer medical care when a psychiatric diagnosis is disclosed. Anti-stigma interventions for the target group of nurses are therefore promising for achieving improved healthcare for people with mental illness.
This study investigates whether a participatory anti-stigma seminar for nurses in training can lead to a significant reduction in stigmatising attitudes towards severe mental illness (SMI).
Who can participate?
Nurses in training who are training at the nursing school of the University Medical Centre Hamburg-Eppendorf, Germany
What does the study involve?
Participation in the study involves one-time attendance at a participatory anti-stigma seminar (intervention seminar) or attendance at a non-participatory seminar on psychiatry and psychotherapy (control seminar). Classes of the nursing school are randomly allocated to the intervention or control seminar. Participants complete questionnaires on stigma, mental health literacy, micro-aggression, and preparedness and confidence in working in mental health nursing at three points in time directly before the start of the seminar, after the end of the seminar and as a follow-up after 3 months.
What are the possible benefits and risks of participating?
The benefit of participating in the study is the opportunity to learn more about stigma, psychiatry and psychotherapy and to question one's own stigmatising attitudes. In the long term, this should improve the care provided by nurses for people with SMI.
The risk of participating in the study is the confrontation with potentially stressful content from mental health crises. Mental health staff are available for the participants throughout the seminar.
Where is the study run from?
University Medical Centre Hamburg-Eppendorf (Germany)
When is the study starting and how long is it expected to run for?
July 2023 to December 2025
Who is funding the study?
Federal Ministry of Health (Germany)
Who is the main contact?
Dr Candelaria Mahlke, c.mahlke@uke.de
Contact information
Public, Scientific
Martinistreet 52
Hamburg
20251
Germany
 ORCID ID |
0000-0002-3064-8380 |
|---|---|
| Phone | +49 (0)40-7410-58933 |
| r.nixdorf@uke.de |
Principal Investigator
Martinistreet 52
Hamburg
20251
Germany
| ORCID ID |
0000-0001-9573-6106 |
|---|---|
| Phone | +49 (0)40-7410-58933 |
| c.mahlke@uke.de |
Public, Scientific
Martinistreet 52
Hamburg
20251
Germany
| ORCID ID |
0009-0006-3437-7406 |
|---|---|
| Phone | +49 (0)40-7410-58933 |
| le.nugent@uke.de |
Study information
| Study design | Interventional single-centre cluster-randomized non-blind controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | Training facility/simulation, University/medical school/dental school |
| Study type | Other |
| Participant information sheet | Not available in web format, please use the contact details to request a participant information sheet |
| Scientific title | Cluster randomised evaluation of a participatory anti-stigma seminar for nurses in training compared with a non-participatory control seminar to assess the reduction of stigmatising attitudes towards severe mental illness (SMI). [Cluster-randomisierte Evaluation eines partizipativen Anti-Stigma-Seminars für Auszubildene in der Pflege im Vergleich zu einem nicht partizipativen Kontrollseminar in Bezug auf die Reduktion von stigmatisierenden Einstellungen gegenüber schweren psychischen Erkrankungen (SMI)] |
| Study objectives | The study investigates whether a participatory anti-stigma seminar can reduce stigmatising attitudes among nurses in training towards severe mental illness (SMI). The following hypotheses regarding the effectiveness of the intervention will be tested: 1. Nurses in training who attended the participatory anti-stigma seminar show significantly less stigmatising attitudes towards SMI after the seminar compared to nurses in training who attended the non-participatory control seminar. 2. Nurses in training who attended the participatory anti-stigma seminar show significantly less micro-aggression behaviors perpetrated towards persons with mental illness after the seminar compared to nurses in training who attended the non-participatory control seminar. 3. Nurses in training who attended the participatory anti-stigma seminar show significantly more preparedness and confidence in working in mental health nursing after the seminar compared to nurses in training who attended the non-participatory control seminar. |
| Ethics approval(s) |
Approved 22/04/2024, Local Psychological Ethics Committee at the Centre for Psychosocial Medicine of the University Medical Centre Hamburg-Eppendorf, Germany [Lokale Psychologische Ethikkommission am Zentrum für Psychosoziale Medizin (LPEK) des Universitätsklinikums Hamburg-Eppendorf, Deutschland] (University Medical Centre Hamburg-Eppendorf, Martinistreet 52, Hamburg, 20251, Germany; +49 (0)40 7410 – 0; LPEK@uke.de), ref: LPEK-0727 |
| Health condition(s) or problem(s) studied | Stigmatising attitudes towards severe mental illness (SMI) |
| Intervention | The intervention is implemented at the nursing school of the University Medical Centre Hamburg-Eppendorf, Germany. The intervention is a participatory, contact-based anti-stigma seminar. The seminar consists of four parts, including self-awareness, information, dialogue and reflection. The focus is on destigmatising contact between the participants through encounters with individuals with lived experience of mental health crises. The seminar comprises six lessons of 45 minutes each. It is led by at least three speakers, at least one of whom has lived experience of mental health crises, one of whom has experience of working in the psychiatric system and one of whom has experience from the perspective of a relative. In two preliminary studies, the seminar concept has already been tested for its effectiveness in reducing stigmatising attitudes among medical students and police officers and has been adapted to the target group of nurses in training. The control seminar will be a non-participatory seminar. It will take a similar amount of time to the intervention seminar. The seminar will only be led by a speaker who has experience working in the psychiatric system. The content of the control seminar covers knowledge of mental health issues. It is methodically parallelised to the intervention seminar. Either the intervention or the control seminar is only offered once per class at the nursing school. All classes in the nursing school are randomised as a cluster and randomly assigned to the intervention or control conditions. The randomization will be carried out using a permuted-block randomization, to guarantee the same number of classes in each arm. Therefore, a randomisation list based on all classes of the nursing school will be created using an online randomization tool. Before the seminar begins, informed consent is obtained for participation in the study and the baseline measurement (T0) is completed. A second measurement (T1) is completed at the end of the seminar. Both measurements are carried out with paper and pencil. Participants who agree to be contacted again will be contacted 3 months after the end of the seminar to participate online in a follow-up measurement (T2). |
| Intervention type | Other |
| Primary outcome measure | Stigmatising attitudes towards SMI will be assessed at baseline (before the seminar begins), at T1 (after the seminar) and at a 3-month follow-up using a questionnaire. The questionnaire was developed in a participatory manner as part of this project. |
| Secondary outcome measures | 1. Stigmatising attitudes will be assessed using the Opening Minds Stigma Scale for Healthcare Providers at baseline (before the seminar begins), at T1 (after the seminar) and at a 3-month follow-up. 2. Micro-aggression behaviors perpetrated towards persons with mental illness will be assessed using the Mental Illness Microaggressions Scale-Perpetrator Version (MIMS-P) at baseline (before the seminar begins), at T1 (after the seminar) and at a 3-month follow-up 3. Preparedness and confidence in working in mental health nursing will be assessed using nine items from Foster et al. (2019), who adapted a survey by Hayman-White & Happell (2005) at baseline (before the seminar begins), at T1 (after the seminar) and at a 3-month follow-up. The items will be translated to German. |
| Overall study start date | 01/07/2023 |
| Completion date | 31/12/2025 |
Eligibility
| Participant type(s) | Learner/student |
|---|---|
| Age group | Mixed |
| Lower age limit | 15 Years |
| Upper age limit | 65 Years |
| Sex | Both |
| Target number of participants | A full enrolment of all trainees undergoing training at the nursing school during the recruitment period is planned. |
| Total final enrolment | 360 |
| Key inclusion criteria | 1. Participants must be trainees at the nursing school of the University Medical Centre Hamburg-Eppendorf, Germany 2. Participants must not have missed more than one lesson of the seminar in total 3. Participants must provide informed consent for study participation 4. Participants must be fluent in the German language |
| Key exclusion criteria | Participants will be excluded: 1. If they are not trainees at the nursing school of the University Medical Centre Hamburg-Eppendorf, Germany 2. If they miss more than one lesson of the seminar in total 3. If they are unable or unwilling to provide written informed consent for study participation 4. If they do not have sufficient knowledge of German to answer the questionnaires |
| Date of first enrolment | 01/11/2024 |
| Date of final enrolment | 12/06/2025 |
Locations
Countries of recruitment
- Germany
Study participating centre
University Medical Centre Hamburg-Eppendorf
Martinistreet 52
Hamburg
20251
Germany
Sponsor information
Hospital/treatment centre
Martinistreet 52
Hamburg
20251
Germany
| Phone | +49 (0)40 7410 - 0 |
|---|---|
| info@uke.de | |
| Website | http://www.uke.de/ |
"ROR" |
https://ror.org/01zgy1s35 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- Federal Ministry of Health, Germany, Federal Ministry of Health, BMG
- Location
- Germany
Results and Publications
| Intention to publish date | 31/12/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Submission of publication of study results is planned within up to 12 month after recruitment is finished in a peer reviewed, open access journal with expertise in mental health, stigma and/ or nursing. If considered appropriate, publication in a German-language psychiatric journal is also being considered. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon request from Dr Candelaria Mahlke (c.mahlke@uke.de). |
Editorial Notes
02/07/2025: The date of final enrolment was changed from 31/07/2025 to 12/06/2025. Total final enrolment added.
06/11/2024: Study's existence confirmed by the Local Psychological Ethics Committee at the Centre for Psychosocial Medicine of the University Medical Centre Hamburg-Eppendorf, Germany.
