Title: Development of self-assessment scale of difficulties in nursing practice of individuals with major depressive disorder: Process of developing scale item proposal
Abstract:
Background: Recently, the number of individuals with depression has increased (WHO, 2023). Although there are many guidelines for the management of major depressive disorder (MDD) (Lee et al., 2020), the medical treatment of depression has become more complex because of the ineffectiveness of standard therapeutic interventions and large number of recurrent cases (Rush et al., 2004) (Walter, 2023) (McAllister, 2022). According to the results of a scoping review, the symptoms of MDD and their psychological reactions made it difficult for nurses to consider daily life support and intervention methods and nurses felt negative emotions, helplessness, and guilt. These results suggest that nurses involved in the nursing practice of individuals with MDD need educational support to understand the symptoms, psychological reactions, and mental health support for nurses' psychological responses to interventions. Difficulties in the nursing practice of individuals with MDD were predominantly based on qualitative data. Therefore, it is necessary to quantitatively investigate the difficulties in the nursing practice of individuals with MDD (Oshima et al., in preparation).
Objective: This study aimed to examine the constructs and frameworks and develop item proposals of a self-assessment scale of difficulties in the nursing practice of individuals with MDD.
Methods: This mixed-methods study used an exploratory sequential design.
In the first phase of qualitative data collection and analysis, the results of interviews with nurses (Oshima et al., 2024) and a scoping review (Oshima et al., in preparation) were used to develop an item proposal scale using the KJ method. The item proposal was revised by evaluating face and content validity of four nurses and two Certified Nurse Specialists in Psychiatric Mental Health Nursing. In the second phase, the scale will be developed by quantitative data collection and analyses. Third, the measurement scale will be verified. In this presentation, we report on the first phase.
Results: Thirty proposed items were determined in the study, comprising 11 items based on interviews, 17 items based on the scoping review, and two items added based on the validity evaluation. The proposed items included the difficulty of communicating with individuals with MDD, providing necessary care while listening to their feelings, providing care with a futuristic view, improving and preventing declined self-esteem, maintaining important beliefs in interacting with them, conflicts faced by nurses in interacting with them, refusal of diagnosis and treatment, providing suicide prevention support, coordinating with medical teams in supporting community living, and lack of specialized support.
Conclusion: Thirty items were extracted as a draft self-assessment scale for difficulties in the nursing practice of individuals with MDD. Therefore, a pilot survey will be conducted eventually.
