Doctorate in Clinical Psychology: Main Research Portfolio.

: 1) The Role of Clinical Psychology in Acute Intensive Care Units (ICUs) in the UK: A Systematic Review and Narrative Synthesis; 2) Exploring Families' Experiences of a Newly Commissioned Specialist CAMHS Service for Refugees and Those Seeking Asylum: A Baseline Clinical Audit of Guideline Concordance to Inform Service Improvements; 3) "A Frightened Forty-Year-Old Man With Schizophrenia? No One Wants to Hold His Hand": A Mixed Methods Study of ICU Nurses' Knowledge, Skills, and Attitudes Toward Mental Illness.

Abstract

Background: Mental ill-health is common in intensive care unit (ICU) patients. Those with comorbid physical and mental health (MH) issues face dual disadvantage, forming a vulnerable cohort. Research indicates ICU nurses seldom receive MH training, leaving them unprepared and unequipped to care for patients with mental illness. Stigmatised attitudes from ICU nurses toward mental illness are well-documented. The Knowledge, Skills, and Attitudes (KSA) model suggests KSA may mutually reinforce one another within clinical practice. Aim: To explore ICU nurses’ KSA toward mental illness through data triangulation. Design: Mixed-methods convergent parallel design. Method: One-hundred and forty ICU nurses were recruited via purposive social media sampling to complete a survey assessing KSA, with the option to participate in a follow-up interview. Twelves nurses were interviewed.7Results: Three themes in nurse narratives were identified using Reflexive Thematic Analysis and were conceptualised within an ecological framework: (1) The Lone Specialist Chameleon Nurse; (2) Stigma in the System; (3) Siloed Systems: Mind the Gap. Survey findings reinforced the interrelationships between KSA domains (knowledge-skills; knowledge-attitudes; skills-attitudes) and suggested demographic influences in shaping these. However, what emerged most strongly was the emotional and affective domain under pinning this work. Conclusions: While training plays a key role in developing ICU nurses’ KSA, both intrinsic nurse characteristics and the wider systemic context in which ICU nurses work are important twofold. Implications: Findings suggest systemic and multidisciplinary implications for ICU practice and policy. Nurse education and training could benefit from systemic reform to better integrate MH care in ICU settings. Changes within the ICU cultural context may help reduce MH stigma, foster a greater sense of support, and alleviate the sense of isolation experienced by nurses. Methodological limitations, and future research directions are discussed.

Date of Award	10 Sept 2025
Original language	English
Awarding Institution	University of Bath
Supervisor	Rachel Paskell (Supervisor) & Josh Valoroso (Supervisor)