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研究生: 趙興融
論文名稱: 健康專業族群心理健康素養量表發展之研究
Development of Mental Health Literacy Scale for the Health Professionals Group (MHLS-HPG)
指導教授: 連盈如
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2019
畢業學年度: 107
語文別: 中文
論文頁數: 88
中文關鍵詞: 心理健康素養精神疾病污名評量工具醫學教育公共衛生教育
英文關鍵詞: Mental health literacy, Mental illness stigma, Measurement, Medical education, Public health education
DOI URL: http://doi.org/10.6345/NTNU201900592
論文種類: 學術論文
相關次數: 點閱:561下載:20
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  • 研究背景及目的:心理健康素養概念持續演進且具有不同組成要素,至今尚未有針對健康專業人員與學生所建構的心理健康素養量表。此一年期研究計畫目的為針對健康專業族群發展心理健康素養量表,並檢驗此心理健康素養量表的心理計量特徵。

    研究方法:本研究對象為臺灣的11所大學醫學系與公共衛生科系三年級以上學生。健康專業族群心理健康素養量表的發展可分為三個階段:1) 根據最新的心理健康素養定義及文獻回顧結果發展評量工具,並透過健康照護領域專家焦點團體訪談確認此量表之內容效度;2) 預試 (N = 32);3) 量表建構,透過項目分析、因素分析(包含探索性與驗證性因素分析)進行題目刪減,並且檢驗內部一致性信度、聚斂效度、區辨效度,以及已知團體效度 (N = 1294)。

    研究結果:本26題的量表為五因素的架構:維持與促進心理健康、疾病辨識與認識、精神疾病去污名、求助效能、求助態度。本量表具備良好的內部一致性信度 Cronbach’s α = .81,分量表信度介於 .70(疾病辨識與認識)至 .87(維持與促進心理健康)之間。心理健康素養越高的人與較低的社會距離,以及較佳的心理健康狀況相關。過去精神疾病患者接觸經驗程度較高者,其心理健康素養較對照組高。

    研究結論:本研究針對健康專業族群所發展之五因素心理健康素養的量表具備良好的信、效度,此研究結果能補充並擴展現今心理健康素養之評量工具。此量表未來將可作為健康專業人員及學生之心理健康素養調查及介入研究之評估工具。

    Background and Aims: Mental health literacy (MHL) is an evolving construct with distinct components. To date, there are no published scales assessing MHL of health professionals and students. This study aims to develop a new scale-based measure of MHL in the health professional group, which assesses multiple components of MHL and its psychometric properties.

    Methods: The participants were undergraduates from the department of medicine and public health among 11 universities in Taiwan. The development of the Mental Health Literacy Scale for the Health Professional Groups (MHLS-HPG) was done over three key stages: 1) measure development based on the latest definition of MHL, a narrative literature review, and focus group interviews including professionals across the disciplines in healthcare to confirm content validity, 2) pilot testing (N = 32), and 3) scale construction, item reduction through item analysis and factor analysis (including exploratory and confirmatory factor analysis), and assessment of internal consistency, convergent validity, discriminant validity and known group validity (N = 1294).

    Results: Twenty-six items with five factors were generated: obtaining and maintaining positive mental health, recognition of mental illness, reducing mental illness stigma, help-seeking efficacy, and help-seeking attitude. The internal consistency for the total scale was good (Cronbach’s α = .81). The α values for the five subscales ranged from .70 (recognition of mental illness) to .87 (obtaining and maintaining positive mental health). Higher MHL was associated with lower social distance and better mental health, respectively. Participants having familiarity with mental illness had higher MHL than their counterparts.

    Conclusions: A valid and reliable five-dimensional instrument of MHL for the health professional group was developed. Our findings have the potential to complement and expand the current measures of MHL. This measure can be used in assessing levels of MHL and in determining the impacts of interventions to improve MHL in health professionals and students.

    第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 4 第三節 名詞界定 4 第二章 文獻探討 5 第一節 心理健康素養 5 一、心理健康素養的概念演進 5 二、心理健康素養的重要性 7 第二節 健康專業人員的心理健康素養 9 一、健康專業人員心理健康的問題 9 二、健康專業人員對於精神疾患的辨識 11 三、健康專業人員對於精神疾患的污名 12 四、健康專業人員尋求精神醫療協助的狀況 13 五、小結 15 第三節 心理健康素養評量工具之探討 17 一、心理健康素養評量工具的類型 17 二、心理健康素養量表式的評量工具 18 第三章 研究方法 25 第一節 研究對象 25 一、預試樣本 25 二、正式樣本 27 第二節 研究工具 29 一、心理健康素養量表 29 二、熟悉程度量表 (Level of Familiarity Questionnaire) 36 三、社會距離量表 (Social Distance Questionnaire) 37 四、正向心理健康量表 (Positive Mental Health Scale) 38 第三節 資料處理與分析 39 第四章 研究結果 45 第一節 項目分析 45 第二節 信度與效度檢驗 45 第五章 討論與結論 61 第一節 討論 61 一、心理健康素養的重要內涵 61 二、量表中各個重要內涵對應之操作型定義 62 三、量表之建構效度結果 64 四、研究優勢 66 第二節 研究限制與未來研究建議 68 第三節 結論 70 參考文獻 71 一、中文部分 71 二、英文部分 72

    一、中文部分
    余民寧、李仁豪(2008)。調查方式與議題熟悉度對問卷回收率與內容的影響,教育學刊,30,101-140。
    邱皓政(2012)。量化研究法(三):測驗原理與量表發展技術。臺北市:雙葉書廊。
    張偉豪(2011)。 SEM 論文寫作不求人(第一版)。高雄:鼎茂圖書出版股份有限公司。
    張淑敏(2013)。注意力不足/過動症病童照顧者心理健康素養研究(未出版之碩士論文)。長榮大學,台南市。
    陳怡伶(2013)。台南市社區志工之老人心理健康素養調查研究(未出版之碩士論文)。長榮大學,台南市。
    游森期、余民寧(2006)。網路問卷與傳統問卷之比較:多樣本均等性方法學之應用,測驗學刊,53,103-127。
    衛生福利部統計處(2018)。社會統計年報-身心障礙人數。 

    二、英文部分
    Acker, G. M. (2010). The challenges in providing services to clients with mental illness: Managed care, burnout and somatic symptoms among social workers. Community Mental Health Journal, 46(6), 591-600.
    Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior Human Decision Processes, 50(2), 179-211.
    Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behaviour. Englewood Cliffs, NJ: Prentice-Hall.
    Alonso, J., Codony, M., Kovess, V., Angermeyer, M. C., Katz, S. J., Haro, J. M., . . . Vilagut, G. (2007). Population level of unmet need for mental healthcare in Europe. The British Journal of Psychiatry, 190(4), 299-306.
    Angermeyer, M. C., Holzinger, A., & Matschinger, H. (2009). Mental health literacy and attitude towards people with mental illness: A trend analysis based on population surveys in the eastern part of Germany. European Psychiatry, 24(4), 225-232.
    Angermeyer, M. C., Holzinger, A., & Matschinger, H. (2010). Emotional reactions to people with mental illness. Epidemiology and Psychiatric Sciences, 19(1), 26-32.
    Angermeyer, M. C., Matschinger, H., & Corrigan, P. W. (2004). Familiarity with mental illness and social distance from people with schizophrenia and major depression: Testing a model using data from a representative population survey. Schizophrenia Research, 69(2-3), 175-182.
    Armitage, C. J., & Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta‐analytic review. British Journal of Social Psychology, 40(4), 471-499.
    Bagozzi, R. P., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74-94.
    Barney, L. J., Griffiths, K. M., Jorm, A. F., & Christensen, H. (2006). Stigma about depression and its impact on help-seeking intentions. Australian New Zealand Journal of Psychiatry, 40(1), 51-54.
    Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588.
    Björkman, T., Angelman, T., & Jönsson, M. (2008). Attitudes towards people with mental illness: A cross‐sectional study among nursing staff in psychiatric and somatic care. Scandinavian Journal of Caring Sciences, 22(2), 170-177.
    Bjørnsen, H. N., Ringdal, R., Espnes, G. A., & Moksnes, U. K. (2017). Positive mental health literacy: Development and validation of a measure among Norwegian adolescents. BMC Public Health, 17(1), 717-726.
    Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.
    Bor, J. S. (2015). Among the elderly, many mental illnesses go undiagnosed. Health Affairs, 34(5), 727-731.
    Borritz, M., Rugulies, R., Bjorner, J. B., Villadsen, E., Mikkelsen, O. A., & Kristensen, T. S. (2006). Burnout among employees in human service work: Design and baseline findings of the PUMA study. Scandinavian Journal of Public Health, 34(1), 49-58.
    Brent, D. A., Oquendo, M., Birmaher, B., Greenhill, L., Kolko, D., Stanley, B., . . . Ellis, S. (2002). Familial pathways to early-onset suicide attempt: Risk for suicidal behavior in offspring of mood-disordered suicide attempters. Archives of General Psychiatry, 59(9), 801-807.
    Cabassa, L. J., & Zayas, L. H. (2007). Latino immigrants' intentions to seek depression care. American Journal of Orthopsychiatry, 77(2), 231-242.
    Callaghan, P., Shan, C. S., Yu, L. S., Ching, L. W., & Kwan, T. i. L. (1997). Attitudes towards mental illness: Testing the contact hypothesis among Chinese student nurses in Hong Kong. Journal of Advanced Nursing, 26(1), 33-40.
    Campbell‐Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the Connor–Davidson resilience scale (CD‐RISC): Validation of a 10‐item measure of resilience. Journal of Traumatic Stress, 20(6), 1019-1028.
    Campos, L., Dias, P., Palha, F., Duarte, A., & Veiga, E. (2016). Development and psychometric properties of a new questionnaire for assessing Mental Health Literacy in young people. Universitas Psychologica, 15(2), 61-72.
    Carter, R., Satcher, D., & Coelho, T. (2013). Addressing stigma through social inclusion. American Journal of Public Health, 103(5), 773.
    Chapman, R., & Orb, A. (2001). Coping strategies in clinical practice: The nursing students’ lived experience. Contemporary Nurse, 11(1), 95-102.
    Clarke, M., Whitty, P., Browne, S., McTigue, O., Kamali, M., Gervin, M., . . . O'callaghan, E. (2006). Untreated illness and outcome of psychosis. The British Journal of Psychiatry, 189(3), 235-240.
    Coentre, R. M., & Figueira, M. L. (2015). Depression and suicidal behavior in medical students: A systematic review. Current Psychiatry Reviews, 11(2), 86-101.
    Cohen, R. J., Swerdlik, M. E., & Phillips, S. M. (2005). Psychological testing and assessment: An introduction to tests and measurement (6 ed.): Mayfield Publishing Co.
    Compton, M. T., Carrera, J., & Frank, E. (2008). Stress and depressive symptoms/dysphoria among US medical students: Results from a large, nationally representative survey. The Journal of Nervous Mental Disease, 196(12), 891-897.
    Comrey, A. L., & Lee, H. B. (2013). A first course in factor analysis: Psychology Press.
    Conner, M. (2010). Cognitive determinants of health behavior Handbook of behavioral medicine (pp. 19-30). New York, US: Springer.
    Corrigan, P. W. (2016). Lessons learned from unintended consequences about erasing the stigma of mental illness. World Psychiatry, 15(1), 67-73.
    Corrigan, P. W., Green, A., Lundin, R., Kubiak, M. A., & Penn, D. L. (2001). Familiarity with and social distance from people who have serious mental illness. Psychiatric Services, 52(7), 953-958.
    Corrigan, P. W., Lurie, B. D., Goldman, H. H., Slopen, N., Medasani, K., & Phelan, S. (2005). How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatric Services, 56(5), 544-550.
    Corrigan, P. W., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162-179.
    Costello, A., & Osborne, J. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Pract Assess, Res Eval. Practical Assessment, Research & Evaluation, 10(7), 1-9.
    Davis, C. S., Massey, O. T., Smith, R. B., Armstrong, M., Vergon, K. S., & Smith, R. B. (2008). Refinement of an instrument to measure mental health literacy among caregivers and providers and a qualitative examination of interventions to enhance mental health literacy. Tampa, FL: Louis de la Parte Florida Mental Health Institute. University of South Florida.
    Deci, E. L., & Vansteenkiste, M. (2004). Self-determination theory and basic need satisfaction: Understanding human development in positive psychology. Ricerche di psicologia, 27(1), 23-40.
    Deen, T. L., & Bridges, A. (2011). Depression literacy: Rates and relation to perceived need and mental health service utilization in a rural American sample. Rural Remote Health, 11(4), 1803.
    DesCamp, R., & Talarico, E. (2016). Provider burnout and resilience of the healthcare team. Journal of Family Medicine Community Health, 3(6).
    DeVellis, R. F. (2016). Scale development: Theory and applications (Vol. 26). Thousand Oaks, CA: Sage publications.
    Dias, P., Campos, L., Almeida, H., & Palha, F. (2018). Mental health literacy in young adults: Adaptation and psychometric properties of the Mental Health Literacy Questionnaire. International Journal of Environmental Research Public Health, 15(7), 1318.
    Druss, B. G. (2006). Rising mental health costs: What are we getting for our money? Health Affairs, 25(3), 614-622.
    Dyrbye, L. N., Massie, F. S., Eacker, A., Harper, W., Power, D., Durning, S. J., . . . Sloan, J. (2010). Relationship between burnout and professional conduct and attitudes among US medical students. Journal of American Medical Association, 304(11), 1173-1180.
    Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Journal of Academic Medicine, 81(4), 354-373.
    Elliot, L., Tan, J., & Norris, S. (2010). The mental health of doctors: A systematic literature review: Beyond Blue.
    Esterberg, M. L., Compton, M. T., Mcgee, R., Shim, R., & Hochman, K. (2008). Knowledge about schizophrenia and social distance toward individuals with schizophrenia: A survey among predominantly low-income, urban, African American community members. Journal of Psychiatric Practice, 14(2), 86-93.
    Feret, H., Conway, L., & Austin, J. C. (2011). Genetic counselors’ attitudes towards individuals with schizophrenia: Desire for social distance and endorsement of stereotypes. Patient Education Counseling, 82(1), 69-73.
    Fischer, E. H., & Turner, J. I. (1970). Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting Clinical Psychology, 35(1), 79-90.
    Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. New York, NY, US: Psychology Press.
    Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39-50.
    Fu, S. T., Lee, C. S., Gunnell, D., Lee, W. C., & Cheng, T. A. (2013). Changing trends in the prevalence of common mental disorders in Taiwan: A 20-year repeated cross-sectional survey. The Lancet, 381(9862), 235-241.
    Furnham, A., & Hamid, A. (2014). Mental health literacy in non-western countries: A review of the recent literature. Mental Health Review Journal, 19(2), 84-98.
    Gabriel, A., & Violato, C. (2010). Depression literacy among patients and the public: A literature review. Primary Psychiatry, 17(1), 21-30.
    Galán, F., Sanmartín, A., Polo, J., & Giner, L. (2011). Burnout risk in medical students in Spain using the Maslach Burnout Inventory-Student Survey. International Archives of Occupational Environmental Health, 84(4), 453-459.
    Glick, I. D. (2004). Undiagnosed bipolar disorder: New syndromes and new treatments. Primary Care Companion to the Journal of Clinical Psychiatry, 6(1), 27-33.
    Goldney, R. D., Fisher, L. J., Wilson, D. H., & Cheok, F. (2002). Mental health literacy of those with major depression and suicidal ideation: An impediment to help seeking. Suicide Life-threatening Behavior, 32(4), 394-403.
    Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. The British Journal of Psychiatry, 185(4), 342-349.
    Griffiths, K. M., Nakane, Y., Christensen, H., Yoshioka, K., Jorm, A. F., & Nakane, H. (2006). Stigma in response to mental disorders: A comparison of Australia and Japan. BMC Psychiatry, 6(1), 21.
    Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10(1), 113.
    Guthrie, E., Black, D., Bagalkote, H., Shaw, C., Campbell, M., & Creed, F. (1998). Psychological stress and burnout in medical students: A five-year prospective longitudinal study. Journal of the Royal Society of Medicine, 91(5), 237-243.
    Hadlaczky, G., Hökby, S., Mkrtchian, A., Carli, V., & Wasserman, D. (2014). Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: A meta-analysis. International Review of Psychiatry, 26(4), 467-475. doi: 10.3109/09540261.2014.924910
    Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2009). Multivariate data analysis (7th ed.). Harlow, United Kingdom: Pearson Education Limited.
    Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis (6th ed.). New Jersey, US: Prentice-Hall.
    Ham, C., Berwick, D., & Dixon, J. (2016). Improving quality in the English NHS: A strategy for action Retrieved from https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Improving-quality-Kings-Fund-February-2016.pdf
    Happell, B. (2008). Changing their minds: Using clinical experience to'convert'undergraduate nursing students to psychiatric nursing. International Journal of Psychiatric Nursing Research, 14(1), 1776-1784.
    Hohwü, L., Lyshol, H., Gissler, M., Jonsson, S. H., Petzold, M., & Obel, C. (2013). Web-based versus traditional paper questionnaires: A mixed-mode survey with a Nordic perspective. Journal of Medical Internet Research, 15(8), e173-e173. doi: 10.2196/jmir.2595
    Honberg, R., Diehl, S., Kimball, A., Gruttadaro, D., & Fitzpatrick, M. (2011). State mental health cuts: A national crisis. Retrieved from https://www.nami.org/getattachment/About-NAMI/Publications/Reports/StateMentalHealthCuts2.pdf.
    Horsfall, J., Cleary, M., & Hunt, G. E. (2010). Stigma in mental health: Clients and professionals. Issues in Mental Health Nursing, 31(7), 450-455.
    Hotopf, M., & Chaplin, R. (2000). Psychiatrists can cause stigma too. The British Journal of Psychiatry, 177(5), 467-470.
    Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55.
    Hugo, M. (2001). Mental health professionals’ attitudes towards people who have experienced a mental health disorder. Journal of Psychiatric Mental Health Nursing, 8(5), 419-425.
    Hung, B. J., Huang, X. Y., & Lin, M. J. (2009). The first experiences of clinical practice of psychiatric nursing students in Taiwan: A phenomenological study. Journal of Clinical Nursing, 18(22), 3126-3135.
    Jorm, A. F. (2000). Mental health literacy: Public knowledge and beliefs about mental disorders. The British Journal of Psychiatry, 177(5), 396-401.
    Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231.
    Jorm, A. F. (2015). Why we need the concept of “mental health literacy”. Health Communication, 30(12), 1166-1168.
    Jorm, A. F., & Kitchener, B. A. (2011). Noting a landmark achievement: Mental health first aid training reaches 1% of Australian adults. Australian and New Zealand Journal of Psychiatry, 45(10), 808-813.
    Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., & Henderson, S. (1999). Attitudes towards people with a mental disorder: A survey of the Australian public and health professionals. Australian New Zealand Journal of Psychiatry, 33(1), 77-83.
    Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). "Mental health literacy": A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166(4), 182-186.
    Jorm, A. F., Korten, A. E., Jacomb, P. A., Rodgers, B., Pollitt, P., Christensen, H., & Henderson, S. (1997). Helpfulness of interventions for mental disorders: Beliefs of health professionals compared with the general public. The British Journal of Psychiatry, 171(3), 233-237.
    Jorm, A. F., Wright, A., & Morgan, A. J. (2007). Where to seek help for a mental disorder? National survey of the beliefs of Australian youth and their parents. The Medical Journal of Australia, 187(10), 556-560.
    Jung, H., Sternberg, K., & Davis, K. (2016). Expanding a measure of mental health literacy: Development and validation of a multicomponent mental health literacy measure. Psychiatry Research, 243, 278-286.
    Jussim, L., Nelson, T. E., Manis, M., & Soffin, S. (1995). Prejudice, stereotypes, and labeling effects: Sources of bias in person perception. Journal of Personality Social Psychology, 68(2), 228-246.
    Kaiser, H. F. (1974). An index of factorial simplicity. Psychometrika, 39(1), 31-36.
    Kassam, A., Papish, A., Modgill, G., & Patten, S. (2012). The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry, 12(1), 62-73.
    Kelly, C. M., Jorm, A. F., & Wright, A. (2007). Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. The Medical Journal of Australia, 187(7), 26-30.
    Kickbusch, I., Pelikan, J. M., Apfel, F., & Tsouros, A. (2013). Health literacy: The solid facts. Geneva (CH): WHO Regional Office for Europe.
    Kim, H. S., Sherman, D. K., Ko, D., & Taylor, S. E. (2006). Pursuit of comfort and pursuit of harmony: Culture, relationships, and social support seeking. Personality Social Psychology Bulletin, 32(12), 1595-1607.
    King, K. A., Vidourek, R. A., & Strader, J. L. (2008). University students' perceived self-efficacy in identifying suicidal warning signs and helping suicidal friends find campus intervention resources. Suicide Life-threatening Behavior, 38(5), 608-617.
    Kitchener, B. A., & Jorm, A. F. (2006). Mental health first aid training: Review of evaluation studies. Australian New Zealand Journal of Psychiatry, 40(1), 6-8.
    Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: Guilford.
    Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111-116.
    Knaak, S., & Patten, S. (2016). A grounded theory model for reducing stigma in health professionals in Canada. Acta Psychiatrica Scandinavica, 134, 53-62.
    Komiya, N., Good, G. E., & Sherrod, N. B. (2000). Emotional openness as a predictor of college students' attitudes toward seeking psychological help. Journal of Counseling Psychology, 47(1), 138-143.
    Kutcher, S., & Wei, Y. (2014). School Mental Health Literacy. Education Canada, 54(2), 22-25.
    Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. The Canadian Journal of Psychiatry, 61(3), 154-158.
    Kutcher, S., Wei, Y., Gilberds, H., Ubuguyu, O., Njau, T., Brown, A., . . . Perkins, K. (2016). A school mental health literacy curriculum resource training approach: Effects on Tanzanian teachers’ mental health knowledge, stigma and help-seeking efficacy. International Journal of Mental Health Systems, 10(1), 50.
    Lamping, D. L., Schroter, S., Marquis, P., Marrel, A., Duprat-Lomon, I., & Sagnier, P. (2002). The community-acquired pneumonia symptom questionnaire: A new, patient-based outcome measure to evaluate symptoms in patients with community-acquired pneumonia. Chest, 122(3), 920-929.
    Lappalainen-Lehto, R., Seppä, K., & Nordback, I. (2005). Cutting down substance abuse—present state and visions among surgeons and nurses. Addictive Behaviors, 30(5), 1013-1018.
    Lauber, C., Nordt, C., Falcato, L., & Rössler, W. (2003). Do people recognise mental illness? European Archives of Psychiatry Clinical Neuroscience, 253(5), 248-251.
    Lee, S., Lee, T. Y., Chiu, Y. L., & Kleinman, A. (2005). Experience of social stigma by people with schizophrenia in Hong Kong. The British Journal of Psychiatry, 186(2), 153-157.
    Li, W., Dorstyn, D. S., & Denson, L. A. (2014). Psychosocial correlates of college students’ help-seeking intention: A meta-analysis. Professional Psychology: Research Practice, 45(3), 163-170.
    Link, B. G., & Cullen, F. T. (1986). Contact with the mentally ill and perceptions of how dangerous they are. Journal of Health Social Behavior, 289-302.
    Link, B. G., Phelan, J. C., Bresnahan, M., Stueve, A., & Pescosolido, B. A. (1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89(9), 1328-1333.
    Lukat, J., Margraf, J., Lutz, R., van der Veld, W. M., & Becker, E. S. (2016). Psychometric properties of the positive mental health scale (PMH-scale). BMC Psychology, 4(1).
    Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543-562.
    Mackenzie, C. S., Knox, V. J., Gekoski, W. L., & Macaulay, H. L. (2004). An adaptation and extension of the attitudes toward seeking professional psychological help scale. Journal of Applied Social Psychology, 34(11), 2410-2433.
    Marsh, H. W., Balla, J. R., & McDonald, R. P. (1988). Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size. Psychological Bulletin, 103(3), 391-410.
    Marsh, H. W., & Hocevar, D. (1985). Application of confirmatory factor analysis to the study of self-concept: First-and higher order factor models and their invariance across groups. Psychological Bulletin, 97(3), 562-582.
    Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout Inventory Manual (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.
    Mazurkiewicz, R., Korenstein, D., Fallar, R., & Ripp, J. (2012). The prevalence and correlations of medical student burnout in the pre-clinical years: A cross-sectional study. Psychology, Health Medicine, 17(2), 188-195.
    McEachan, R., Taylor, N., Harrison, R., Lawton, R., Gardner, P., & Conner, M. (2016). Meta-analysis of the reasoned action approach (RAA) to understanding health behaviors. Annals of Behavioral Medicine, 50(4), 592-612.
    McEachan, R. R. C., Conner, M., Taylor, N. J., & Lawton, R. J. (2011). Prospective prediction of health-related behaviours with the theory of planned behaviour: A meta-analysis. Health Psychology Review, 5(2), 97-144.
    Mendenhall, A. N., Jackson, S. C., & Hase, S. (2013). Mental Health First Aid USA in a rural community: Perceived impact on knowledge, attitudes, and behavior. Social Work in Mental Health, 11(6), 563-577.
    Morgan, A. J., Reavley, N. J., Jorm, A. F., & Beatson, R. (2016). Experiences of discrimination and positive treatment from health professionals: A national survey of adults with mental health problems. Australian New Zealand Journal of Psychiatry, 50(8), 754-762.
    Mueser, K. T., Corrigan, P. W., Hilton, D. W., Tanzman, B., Schaub, A., Gingerich, S., . . . Vogel-Scibilia, S. (2002). Illness management and recovery: A review of the research. Psychiatric Services, 53(10), 1272-1284.
    Murden, F., Bailey, D., Mackenzie, F., Oeppen, R. S., & Brennan, P. A. (2018). The impact and effect of emotional resilience on performance: An overview for surgeons and other healthcare professionals. British Journal of Oral Maxillofacial Surgery, 56(9), 785-790.
    Nordt, C., Rössler, W., & Lauber, C. (2006). Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophrenia Bulletin, 32(4), 709-714.
    Nutbeam, D., Wise, M., Bauman, A., Harris, E., & Leeder, S. (1993). Goals and targets for Australia's health in the year 2000 and beyond: Australian Government Publishing Service, Canberra.
    O'Reilly, C. L., Bell, J. S., Kelly, P. J., & Chen, T. F. (2011). Impact of mental health first aid training on pharmacy students’ knowledge, attitudes and self-reported behaviour: A controlled trial. Australian New Zealand Journal of Psychiatry, 45(7), 549-557.
    O’Connor, M., & Casey, L. (2015). The mental health literacy scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry Research, 229(1), 511-516.
    O’Connor, M., Casey, L., & Clough, B. (2014). Measuring mental health literacy–a review of scale-based measures. Journal of Mental Health, 23(4), 197-204.
    Oliver, M. I., Pearson, N., Coe, N., & Gunnell, D. (2005). Help-seeking behaviour in men and women with common mental health problems: Cross-sectional study. The British Journal of Psychiatry, 186(4), 297-301.
    Peterson, U., Demerouti, E., Bergström, G., Samuelsson, M., Åsberg, M., & Nygren, Å. (2008). Burnout and physical and mental health among Swedish healthcare workers. Journal of Advanced Nursing, 62(1), 84-95.
    Poreddi, V., Thimmaiah, R., Chandra, R., & BadaMath, S. (2015). Bachelor of nursing student'attitude towards people with mental illness and career choices in psychiatric nursing: An Indian perspective. Nursing Research and Education, 33(1), 138-154.
    Portney, L. G., Watkins, M. P. (2000). Foundations of clinical research applications to practice. New Jersey, US: Prentice Hall.
    Puthran, R., Zhang, M. W., Tam, W. W., & Ho, R. C. (2016). Prevalence of depression amongst medical students: A meta‐analysis. Journal of Medical Education, 50(4), 456-468.
    Rao, H., Mahadevappa, H., Pillay, P., Sessay, M., Abraham, A., & Luty, J. (2009). A study of stigmatized attitudes towards people with mental health problems among health professionals. Journal of Psychiatric Mental Health Nursing, 16(3), 279-284.
    Ray, E. B. (1991). The relationship among communication network roles, job stress, and burnout in educational organizations. Communication Quarterly, 39(1), 91-102.
    Ray, E. B., & Miller, K. I. (1991). The influence of communication structure and social support on job stress and burnout. Management Communication Quarterly, 4(4), 506-527.
    Reavley, N. J., McCann, T. V., & Jorm, A. F. (2012). Mental health literacy in higher education students. Early Intervention in Psychiatry, 6(1), 45-52.
    Rong, Y., Luscombe, G. M., Davenport, T. A., Huang, Y., Glozier, N., & Hickie, I. B. (2009). Recognition and treatment of depression. Social Psychiatry Psychiatric Epidemiology, 44(8), 636-642.
    Rotenstein, L. S., Ramos, M. A., Torre, M., Bradley, S., Michael, J. P., Constance, G., . . . Douglas, A. M. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis. Journal of American Medical Association, 316(21), 2214-2236. doi: 10.1001/jama.2016.17324
    Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2008). Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10(1), 2-5.
    Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., & Rollins, A. L. (2017). The relationship between professional burnout and quality and safety in healthcare: A meta-analysis. Journal of General Internal Medicine, 32(4), 475-482.
    Salyers, M. P., Fukui, S., Rollins, A. L., Firmin, R., Gearhart, T., Noll, J. P., . . . Davis, C. J. (2015). Burnout and self-reported quality of care in community mental health. Administration Policy in Mental Health Mental Health Services Research, 42(1), 61-69.
    Santen, S. A., Holt, D. B., Kemp, J. D., & Hemphill, R. R. (2010). Burnout in medical students: Examining the prevalence and associated factors. Southern Medical Journal, 103(8), 758-763.
    Sartorius, N. (2007). Stigma and mental health. The Lancet, 370(9590), 810-811.
    Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2009). The stigma of psychiatric treatment and help-seeking intentions for depression. European Archives of Psychiatry Clinical Neuroscience, 259(5), 298-306.
    Schulze, B. (2007). Stigma and mental health professionals: A review of the evidence on an intricate relationship. International Review of Psychiatry, 19(2), 137-155.
    Seow, L. S. E., Chua, B. Y., Xie, H., Wang, J., Ong, H. L., Abdin, E., . . . Subramaniam, M. (2017). Correct recognition and continuum belief of mental disorders in a nursing student population. BMC Psychiatry, 17(1), 289.
    Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., . . . Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377-1385.
    Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S. (2001). Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric Services, 52(12), 1615-1620.
    Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, P., Friedman, S. J., & Meyers, B. S. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158(3), 479-481.
    Smoot, S. L., & Gonzales, J. L. (1995). Cost-effective communication skills training for state hospital employees. Psychiatric Services, 46(8), 819-822.
    Song, L. Y., Chang, L. Y., Shih, C. Y., Lin, C. Y., & Yang, M. J. (2005). Community attitudes towards the mentally ill: The results of a national survey of the Taiwanese population. International Journal of Social Psychiatry, 51(2), 162-176.
    Spiker, D. A., & Hammer, J. H. (2018). Mental health literacy as theory: Current challenges and future directions. Journal of Mental Health, 28(3), 238-242. doi: 10.1080/09638237.2018.1437613
    Substance Abuse and Mental Health Services Administration. (2014). Results from the 2013 national survey on drug use and health: Mental health findings Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUHmhfr2013/NSDUHmhfr2013.pdf
    Suffoletto, B., Miller, T., Frisch, A., & Callaway, C. (2013). Emergency physician recognition of delirium. Postgraduate Medical Journal, 89(1057), 621-625.
    Taylor, S. M., Dear, M. J., & Hall, G. B. (1979). Attitudes toward the mentally ill and reactions to mental health facilities. Social Science Medicine, 13(4), 281-290.
    Thornicroft, G. (2006). Shunned: Discrimination against people with mental illness. New York, NY: Oxford University Press
    Thornicroft, G., Brohan, E., Kassam, A., & Lewis-Holmes, E. (2008). Reducing stigma and discrimination: Candidate interventions. International Journal of Mental Health Systems, 2(1), 3-9.
    Thornicroft, G., & Maingay, S. (2002). The global response to mental illness: An enormous health burden is increasingly being recognised. British Medical Journal, 325, 608-609.
    Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007). Stigma: Ignorance, prejudice or discrimination? The British Journal of Psychiatry, 190(3), 192-193.
    Tyssen, R., Røvik, J. O., Vaglum, P., Grønvold, N. T., & Ekeberg, Ø. (2004). Help-seeking for mental health problems among young physicians: Is it the most ill that seeks help? Social Psychiatry Psychiatric Epidemiology, 39(12), 989-993.
    Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53(3), 325.
    Vogt, D., Di Leone, B., Wang, J. M., Sayer, N. A., Pineles, S. L., & Litz, B. T. (2014). Endorsed and Anticipated Stigma Inventory (EASI): A tool for assessing beliefs about mental illness and mental health treatment among military personnel and veterans. Psychological Services, 11(1), 105-113.
    Volmer, D., Mäesalu, M., & Bell, J. S. (2008). Pharmacy students' attitudes toward and professional interactions with people with mental disorders. International Journal of Social Psychiatry, 54(5), 402-413.
    Waldman, J. D., Kelly, F., Aurora, S., & Smith, H. L. (2004). The shocking cost of turnover in health care. Health Care Management Review, 29(1), 2-7.
    Walter, G., Soh, L. W., Jaconelli, S. N., Lampe, L., Malhi, G. S., & Hunt, G. (2013). Medical students’ subjective ratings of stress levels and awareness of student support services about mental health. Postgraduate Medical Journal, 89, 311-315.
    Waltz, C. F., Strickland, O., & Lenz, E. R. (2016). Measurement in nursing and health research (5th ed.). New York, US: Springer Publishing Company.
    Wang, J. L., & Lai, D. (2008). The relationship between mental health literacy, personal contacts and personal stigma against depression. Journal of Affective Disorders, 110(1-2), 191-196.
    Wang, J. Y., He, Y. L., Jiang, Q., Cai, J., Wang, W. L., Zeng, Q. Z., . . . Bian, Q. (2013). Mental health literacy among residents in Shanghai. Shanghai Archives of Psychiatry, 25(4), 224-235.
    Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., . . . Gureje, O. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet, 370(9590), 841-850.
    Wang, P. S., Angermeyer, M. C., Borges, G., Bruffaerts, R., Chiu, W. T., De Girolamo, G., . . . Huang, Y. (2007). Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry, 6(3), 177-185.
    Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 603-613.
    Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 629-640.
    Whiteford, H. A., Ferrari, A. J., Degenhardt, L., Feigin, V., & Vos, T. (2015). The global burden of mental, neurological and substance use disorders: An analysis from the Global Burden of Disease Study 2010. PloS One, 10(2), 1-14.
    Williams, B., Onsman, A., & Brown, T. (2010). Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine, 8(3), 1-13.
    Wilson, C. J., Rickwood, D., & Deane, F. P. (2007). Depressive symptoms and help-seeking intentions in young people. Clinical Psychologist, 11(3), 98-107.
    Wolf, T. M. (1994). Stress, coping and health: Enhancing well‐being during medical school. Medical Education, 28(1), 8-17.
    Woodward, A. T., Taylor, R. J., Bullard, K. M., Neighbors, H. W., Chatters, L. M., & Jackson, J. S. (2008). Use of professional and informal support by African Americans and Caribbean blacks with mental disorders. Psychiatric Services, 59(11), 1292-1298. doi: 10.1176/appi.ps.59.11.1292
    World Health Organization. (2001). Mental health: Stop exclusion - dare to care Retrieved from https://www.who.int/world-health-day/previous/2001/files/whd2001_dare_to_care_en.pdf
    World Health Organization. (2013). Mental health action plan 2013 - 2020 Retrieved from https://www.who.int/mental_health/publications/action_plan/en/
    Wright, A., Jorm, A. F., Harris, M. G., & McGorry, P. D. (2007). What’s in a name? Is accurate recognition and labelling of mental disorders by young people associated with better help-seeking and treatment preferences? Social Psychiatry Psychiatric Epidemiology, 42(3), 244-250.
    Yap, M. B. H., Wright, A., & Jorm, A. F. (2011). The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help. Social Psychiatry Psychiatric Epidemiology, 46(12), 1257-1265.
    Yeo, S. G., Parker, G., Mahendran, R., Jorm, A. F., Yap, H. L., Lee, C. S., & Loh, M. I. (2001). Mental health literacy survey of psychiatrically and generally trained nurses employed in a Singapore psychiatric hospital. International Journal of Nursing Practice, 7(6), 414-421.
    Zwack, J., & Schweitzer, J. (2013). If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Academic Medicine, 88(3), 382-389.

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