Mental health nurses' attitudes towards risk assessment: An integrative systematic review.

Abstract

INTRODUCTION: Understanding nurses' attitudes towards risk assessment could inform education and practice improvements. To explore mental health nurses' attitudes towards risk assessment. An integrative systematic review (PROSPERO: CRD42023398287). Multiple databases (PubMed, CINAHL, MEDLINE, EMBASE and PsycINFO) were searched for primary studies of mental health nurses' attitudes towards risk assessment. Qualitative studies were subject to inductive coding and thematic analysis; quantitative data were integrated with emerging themes. Eighteen articles were included. Qualitative studies commonly lacked rigorous analyses. Four themes emerged: underlying purpose and legitimacy of risk assessment (philosophical orientation); use of structured approaches (technical orientation); value of intuition (intuitive orientation); and service user involvement (relationships orientation). There were contradictory study findings in each thematic category indicating different attitudes among mental health nurses. Mental health nurses' attitudes towards risk assessment vary in four key domains. Survey studies suggest they are more approving of structured approaches to risk assessment than many qualitative studies suggest. There is a need to develop a valid measure of attitudes to risk assessment. This review could help health organisations to develop strategies to improve their risk assessment policies and practice. There is a need to develop structured training and education programmes.