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Formulation of a Valid and Reliable Tool to Measure Attitudes towards Mental Health Issues in Undergraduate Physiotherapy Students
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Abstract This summary is of a project awarded a grant from the CSP Charitable Trust.
Formulation of a Valid and Reliable Tool to Measure Attitudes towards Mental Health Issues in Undergraduate Physiotherapy Students Rachel M Spearing MPhil MCSP PGDip DipTP Research undertaken for the award of MPhil at The Manchester (Victoria) University. Copies of the thesis are lodged at the CSP Learning Resource Centre and The John Rylands University Library, Manchester University.
Co-morbid incidence of physical and mental ill health means that physiotherapists will encounter individuals with mental health disorders in their daily practice. A literature review revealed negative attitudes towards people with mental illness among the public and (non-mental) healthcare professionals. Attitudes may be reflected in behaviours, thereby impacting on the interactions between therapists and clients. Anecdotal evidence suggested that undergraduate physiotherapists’ attitudes towards mental health issues were more positive after a unit of study; the researcher wished to explore this more rigorously. No tools were found that had been specifically designed to measure attitudes towards mental health issues in physiotherapists and available tools were inappropriate for the target population. The objective of the study was therefore to formulate a valid and reliable tool to measure attitudes towards mental health issues in undergraduate physiotherapists. A multi-stage methodology was devised to generate a scale that had face, content, construct and context validity: ■ Opinions about mental health issues were sought. Nine volunteer subjects undertook a statement completion exercise and then verbalised their perceptions of others’ views; physiotherapy students described their perceptions of the attitudes of the general public and physiotherapy teachers described their perceptions of students’ attitudes. ■ Two researchers carried out a content analysis of the survey transcripts. Twenty-nine attitude statements were generated and incorporated into the first draft of a questionnaire.
Physiotherapy December 2003/vol 89/no 12
■ A team of five expert judges evaluated the questionnaire, which was amended to produce a second draft with 28 attitude statements.
Performance of the questionnaire was then tested by administering the questionnaire twice with no intervention to a group of volunteer first-year undergraduate physiotherapists. Twenty-two matched responses were analysed. Three pieces of data were missing (out of a possible 1,232). ■ Mann-Whitney U tests demonstrated no significant relationship between sample characteristics and scores. ■ The test-retest reliability of the questionnaire was ascertained using weighted kappa and analysis of response patterns. General consistency in responses between the first and second questionnaire administrations was demonstrated; mode scores were the same for twenty items and 602 of 616 responses showed either total or partial agreement between the first and second questionnaire administrations. The weighted kappa statistic for the scale was ‘moderate’. ■ The Spearman rho was calculated to test the discrimination index of the items and it was found to be significant for 26 items at the 0.01 or 0.05 levels. ■ Factor analysis was considered but rejected.
A recommendation was made that seven ‘problem items’ be removed from the scale and it be reviewed and tested again with a larger random sample, incorporating some methodological changes. Suggested areas for further study included using the scale with cohorts of students at various stages of their education to identify the impact of education and experience on attitudes. Contact Address Ms R M Spearing, Department of Physiotherapy, Manchester Metropolitan University, c/o Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
Abstract This summary is of a project awarded a grant from the CSP Charitable Trust.
Formulation of a Valid and Reliable Tool to Measure Attitudes towards Mental Health Issues in Undergraduate Physiotherapy Students Rachel M Spearing MPhil MCSP PGDip DipTP Research undertaken for the award of MPhil at The Manchester (Victoria) University. Copies of the thesis are lodged at the CSP Learning Resource Centre and The John Rylands University Library, Manchester University.
Co-morbid incidence of physical and mental ill health means that physiotherapists will encounter individuals with mental health disorders in their daily practice. A literature review revealed negative attitudes towards people with mental illness among the public and (non-mental) healthcare professionals. Attitudes may be reflected in behaviours, thereby impacting on the interactions between therapists and clients. Anecdotal evidence suggested that undergraduate physiotherapists’ attitudes towards mental health issues were more positive after a unit of study; the researcher wished to explore this more rigorously. No tools were found that had been specifically designed to measure attitudes towards mental health issues in physiotherapists and available tools were inappropriate for the target population. The objective of the study was therefore to formulate a valid and reliable tool to measure attitudes towards mental health issues in undergraduate physiotherapists. A multi-stage methodology was devised to generate a scale that had face, content, construct and context validity: ■ Opinions about mental health issues were sought. Nine volunteer subjects undertook a statement completion exercise and then verbalised their perceptions of others’ views; physiotherapy students described their perceptions of the attitudes of the general public and physiotherapy teachers described their perceptions of students’ attitudes. ■ Two researchers carried out a content analysis of the survey transcripts. Twenty-nine attitude statements were generated and incorporated into the first draft of a questionnaire.
Physiotherapy December 2003/vol 89/no 12
■ A team of five expert judges evaluated the questionnaire, which was amended to produce a second draft with 28 attitude statements.
Performance of the questionnaire was then tested by administering the questionnaire twice with no intervention to a group of volunteer first-year undergraduate physiotherapists. Twenty-two matched responses were analysed. Three pieces of data were missing (out of a possible 1,232). ■ Mann-Whitney U tests demonstrated no significant relationship between sample characteristics and scores. ■ The test-retest reliability of the questionnaire was ascertained using weighted kappa and analysis of response patterns. General consistency in responses between the first and second questionnaire administrations was demonstrated; mode scores were the same for twenty items and 602 of 616 responses showed either total or partial agreement between the first and second questionnaire administrations. The weighted kappa statistic for the scale was ‘moderate’. ■ The Spearman rho was calculated to test the discrimination index of the items and it was found to be significant for 26 items at the 0.01 or 0.05 levels. ■ Factor analysis was considered but rejected.
A recommendation was made that seven ‘problem items’ be removed from the scale and it be reviewed and tested again with a larger random sample, incorporating some methodological changes. Suggested areas for further study included using the scale with cohorts of students at various stages of their education to identify the impact of education and experience on attitudes. Contact Address Ms R M Spearing, Department of Physiotherapy, Manchester Metropolitan University, c/o Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.