District nursing staff and depression: A psychometric evaluation of Depression Attitude Questionnaire findings

Background Mental health problems such as depression are common in primary care settings and patients with chronic medical problems are at an increased risk. This co-morbidity suggests that district nursing services are particularly likely to encounter psychological problems in their patients. Mental health problems are poorly recognised and inadequately treated in primary care. In part this may be due to stigmatising views of mental illness, which negatively influence help-seeking and user experiences. Likewise providers’ attitudes are likely to play a significant part in the management of such problems. Objectives The aims of this study were extend knowledge of district nursing staff attitudes to depression and explore the psychometric properties of a depression attitude measure used with this staff group. Design and settings The Depression Attitude Questionnaire (DAQ) was used within a postal questionnaire survey of district nursing services in three areas, Jersey (Channel Islands), Lewisham, and Hertfordshire. Participants All staff (community nurses, district nurses and home care staff) were contacted; 217 (66%) staff responded to the survey, and 189 (57%) completed the DAQ. Results Three factors were derived from the DAQ accounting for 47% of the variance. The factor solution appeared stable and provided meaningful dimensions, however the internal consistency of the measure and of its derived subscales was low (Cronbachʹs α between 0.59 and 0.64). The factors were labelled pessimism about depression and its treatment, tendency to defer to specialists, and professional ease in working with depressed patients. Staff responses revealed generally optimistic views concerning depression treatment, strongly rejecting deterministic attitudes to this condition. Conclusions The DAQ has been widely employed to measure and compare attitudes of staff from various disciplines and specialisms. The current evaluation has provided a more detailed examination of its psychometric properties than previously available, but low internal consistency levels indicate further examination of this area is warranted.