title: Why is psychiatric nursing not the preferred option for nursing students: A cross-sectional study examining pre-nursing and nursing school factors.
abstract: BACKGROUND
  There is a shortage of nurses working in the mental health field globally. The aim of the present study was to examine Singapore nursing students' attitudes towards specializing in psychiatric nursing by examining the pre-nursing and nursing school factors as well as attitudes towards psychiatry and personality traits.
  
  
  METHODS
  A cross-sectional online survey was conducted with 500 nursing students from four nursing institutions in Singapore. Students' attitudes towards psychiatry (ATP-18), perception of psychiatric nursing career aspects relative to other fields, and personality traits (mini-IPIP) were assessed. The main outcome measure was likelihood of specializing in psychiatric nursing. Logistic regression was used to examine the combined effect of factors upon the outcome.
  
  
  RESULTS
  Twenty-six students (5.2%) rated "definitely decided to do" psychiatric nursing. Pre-nursing school factors associated with choosing psychiatry included ethnicity, current education, parents' wishes, having personal/family experience of mental illness, prior work experience, interest in psychiatric nursing and psychology module taken prior to current school admission. Nursing school factors such as teaching methods and clinical exposure were not associated with choosing psychiatric nursing. Positive attitudes towards psychiatry, perception of better career aspects in psychiatric nursing relative to other fields, and the personality traits of extraversion and intellect/imagination were associated with likelihood of choosing psychiatric nursing. Logistic regression revealed Malay (OR: 1.90, 1.14-3.16, p=0.013) and Indian ethnicity (OR: 2.56, 1.32-4.96, p=0.005), interest in psychiatry (OR: 22.56, 8.22-61.92, p<0.001), psychology module prior to current school admission (OR: 2.31, 1.28-4.17, p=0.005), better perceived job prospects in psychiatric nursing than other fields (OR: 1.91, 1.21-3.04, p=0.006), extraversion (OR: 1.09, 1.02-1.17, p=0.012) and positive attitude towards psychiatry (OR: 2.72, 1.75-4.23, p<0.001) as factors associated with students choosing psychiatric nursing.
  
  
  CONCLUSIONS
  The selection of psychiatry as a specialty by nursing students was affected by pre-nursing school factors. Taking these factors into consideration may improve recruitment and alleviate the shortages in the psychiatric nursing field.
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore. Electronic address: Hui_Lin_ONG@imh.com.sg.
authors.forename: Hui Lin
authors.initials: HL
authors.lastname: Ong
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore.
authors.forename: Esmond
authors.initials: E
authors.lastname: Seow
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore.
authors.forename: Boon Yiang
authors.initials: BY
authors.lastname: Chua
authors.affiliation: Nursing Training, Department of Nursing Administration, Institute of Mental Health, Singapore, Singapore.
authors.forename: Huiting
authors.initials: H
authors.lastname: Xie
authors.affiliation: Nursing Training, Department of Nursing Administration, Institute of Mental Health, Singapore, Singapore.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore.
authors.forename: Ying Wen
authors.initials: YW
authors.lastname: Lau
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore.
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
authors.affiliation: Department of Research Division, Institute of Mental Health, Singapore, Singapore.
authors.forename: Mythily
authors.initials: M
authors.lastname: Subramaniam
mesh_terms: D001290:Attitude; D002321:Career Choice; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D011568:Psychiatric Nursing; D012579:Schools, Nursing; D012846:Singapore; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Education; Mental health; Nursing students; Psychiatric nursing; Singapore