Stigma, Depression, and Attitudes Towards Seeking Psychological Help Among Nurses: The Role of Personal Stigma as an Inconsistent Mediator

Abstract

Rationale: Identifying whether perceived stigma or personal stigma more significantly affects nurses' attitudes towards seeking psychological help is essential for effectively addressing current challenges and facilitating early intervention for the well-being of nurses and their patients.

Aims and objectives: The aim of this study was to explore the mediating roles of personal stigma and depression in the relationship between perceived stigma among nurses and their attitudes towards seeking psychological help.

Methods: The sample of this descriptive cross-sectional study consisted of 302 nurses working in a university hospital in southern Turkey, selected using the purposive sampling method, between April 1 and May 1, 2021. Data collection tools were Personal Information Form, Attitudes Towards Seeking Psychological Help Scale-Short Form, Depression Stigma Scale, and Beck Depression Inventory. The data were analyzed using SPSS version 26.0. Correlation and regression analyzes were used to examine the relationships between attitudes towards seeking psychological help, personal stigma, perceived stigma, and Beck depression levels. Mann-Whitney U and Kruskal-Wallis tests were employed to compare scale scores across socio-demographic variables. The mediation models were tested with variables such as perceived stigma, personal stigma, and Beck depression levels as mediators. Results were presented with 95% confidence intervals, and significance was set at p < 0.05.

Results: Attitudes towards seeking psychological help were negatively influenced by nurses' stigma levels, especially, by personal stigma levels. Additionally, nurses' attitudes were positively influenced by their unit of work and the presence of a chronic illness, while being male and experiencing higher levels of personal stigma had a negative impact. No significant relationships were found between perceived stigma, personal stigma, and depression levels.

Conclusion: High levels of personal stigma negatively affect attitudes towards seeking psychological help; however, when considered alongside working in oncology and having a chronic illness, the impact of personal stigma becomes positive. Future research should delve deeper into these dynamics to develop targeted strategies for reducing personal stigma and enhancing help-seeking behaviors among nurses. Interventions are necessary to foster positive help-seeking attitudes among nurses and reduce stigma. Aligned with the findings of this study, training and awareness initiatives aimed at improving mental health literacy among nurses can play a pivotal role in reducing stigma and encouraging proactive use of mental health resources.

Keywords: depression; multiple mediation analysis; nursing; seeking psychological help; stigma.