Out on PubMed, from investigators at Yale University and Groningen, The Netherlands, is this study:
Kitay BM, Walde T, Robertson D, Cohen T, Duvivier R, Martin A.J Am Psychiatr Nurses Assoc. 2020 Jul 29:1078390320945778. doi: 10.1177/1078390320945778. Online ahead of print.PMID:
The abstract is copied below:
BACKGROUND: Knowledge gaps and stigmatized perceptions regarding electroconvulsive therapy (ECT) among patients and health providers contribute to the underutilization of an important therapeutic modality. The proactive education of future advanced practice registered nurses (APRNs) provides an opportunity to optimize the use of this evidence-based clinical practice. AIMS: As part of a general course in psychiatry during the first year of nursing school, we dedicated 1 hour to treatment-refractory depression, including ECT, and a second hour to a summary discussion of mood disorders. We evaluated the efficacy of this didactic offering, which was co-taught by a psychiatrist and a psychiatric APRN. METHOD: At baseline, consenting students (n = 94) provided three words they associated with ECT and then completed three validated instruments: (a) Questionnaire on Attitudes and Knowledge of ECT, (b) Opening Minds Stigma Scale for Health Care Providers, and (c) Self-Stigma of Seeking Help. Among the 67 students who repeated the assessment at endpoint, 39 attended the ECT didactic (Intervention group, 58%) and 28 did not (Control, 42%). RESULTS: After completion of the 3-month course, students showed improvement across all measures (p < .001). The only outcomes that improved differentially between the Intervention and Control groups were the Questionnaire on Attitudes and Knowledge of ECT Attitudes and Knowledge scales (p = .01). Word choice valence associated with ECT shifted favorably by endpoint (p < .001). CONCLUSIONS: An educational intervention co-led by a psychiatric-mental health APRN had a significant impact on nursing students' knowledge and perceptions of ECT. This approach can be readily implemented at other institutions. Future refinements will include the videotaped depiction of a simulated patient undergoing the consent, treatment, and recovery phases of ECT.
And from the text:
(Introduction)
...we developed a pilot educational intervention for first-year nursing students in an accelerated program toward an APRN degree. We modeled our didactic intervention as a combined didactic on the subjects of treatment-refractory depression and the role of ECT in modern psychiatric practice. A unique feature of this intervention was the development and dissemination of content by a collaborative duo of a psychiatrist and an APRN working together in an academic ECT service.
(Discussion)
Our study sample included not only nine individuals with a declared commitment to psychiatric specialization but a plurality of nursing students (87%) with other areas of interest. We consider a strength of our study this varied and nonspecialized group of future nurses. In whatever clinical area they ultimately settle to practice in, nurses will be in the frontlines of identifying common psychopathology and be in a position to advocate for appropriate treatment. Indeed, at a global level, nurses and general practitioners increasingly provide first contact care for the detection and management of mental health problems (Heim et al., 2020). Nurses with evidence-based knowledge and unbiased views stand at a critical juncture to advocate for appropriate psychiatric care—including ECT, when clinically indicated.
Decreasing stigma and increasing knowledge about ECT remain crucial public health challenges. The authors are to be commended for their successful effort to improve nursing education/attitudes about ECT with a one hour ECT-specific didactic in the curriculum (in a 4-hour module on mood disorders). Of course, the overarching point to be made is the importance of the nursing role in all aspects of ECT care.
This paper is worth reading in its entirety. One very interesting detail is the presentation of "word clouds," the visual representation of the words, and emotional valence attached to them, that participants associated with ECT, before and after, the educational intervention.
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