[Latent profile analysis of mental health literacy among nurses in tertiary general hospitals in Chongqing, China].

OBJECTIVES: Nurses in general hospitals play a critical role in identifying and managing patients with comorbid physical and mental health conditions. However, under current educational and training systems, their professional competence in mental health often faces limitations. This study aims to identify latent profiles of mental health literacy among nurses in tertiary general hospitals in Chongqing, China, using latent profile analysis (LPA), and to explore associated sociodemographic and occupational factors, thereby providing a scientific basis for targeted and stratified intervention strategies.

METHODS: A cross-sectional study was conducted using a multistage stratified cluster sampling method from April to May 2023. Based on the gross domestic product levels of 38 districts and counties in Chongqing, regions were stratified into high-, medium-, and low-economic levels. A total of nine tertiary general hospitals were randomly selected from each stratum. Nurses meeting the inclusion criteria were recruited using department-based cluster sampling. Data were collected using a self-designed demographic questionnaire and the Chinese version of the Mental Health Literacy Scale (MHLS-C). The MHLS-C comprised four dimensions: knowledge of mental disorders ("knowledge"), ability to seek information and help ("ability"), recognition of mental disorders ("recognition"), and acceptance of individuals with mental illness ("acceptance"). LPA was performed to identify latent profiles, with model fit evaluated using entropy and multiple information criteria. Considering the nested structure of participants within hospitals, multivariable generalized estimating equations (GEE) were used to analyze associated factors, with departments treated as clustering units. The latent profiles are identified based on LPA, and considering the Bayesian information criterion (BIC), sample-size adjusted BIC (aBIC), Akaike information criterion (AIC), and clinical interpretability.

RESULTS: A total of 1 492 valid participants were included, with a mean MHLS-C score of 92.38±10.04. Based on LPA, and considering the BIC, aBIC, AIC, and clinical interpretability, 3 distinct latent profiles were identified: Profile 1 ("low cognition-moderate acceptance", n=90, 6.03%): very low scores in knowledge, ability, and recognition, but moderate acceptance; Profile 2 ("moderate cognition-low acceptance", n= 886, 59.38%): moderate cognitive scores but the lowest acceptance; Profile 3 ("high cognitive-moderate acceptance", n=516, 34.59%): high cognition levels with moderate acceptance. Using Profile 3 as the reference, multivariable GEE analysis showed that nurses who had received professional psychological interventions (OR=3.742, 95% CI 2.124 to 6.592), had not received mental health training (OR=2.136, 95% CI 1.705 to 2.677), or had an annual income ≤100 000 CNY (OR=2.682, 95% CI 1.284 to 5.605) were more likely to be classified into Profile 1 (all P<0.05). Male sex (OR=2.104, 95% CI 1.309 to 3.382), aged≥30 years (OR=1.476, 95% CI 1.013 to 2.150), being married (OR=1.358, 95% CI 1.069 to 1.725), working in intensive care units (OR=2.286, 95% CI 1.543 to 3.387) or surgical departments (OR=1.499, 95% CI 1.141 to 1.969), lack of mental health training (OR=1.573, 95% CI 1.326 to 1.866), employment in county-level hospitals (OR=1.353, 95% CI 1.043 to 1.754), and annual income ≤100 000 CNY (OR=1.558, 95% CI 1.206 to 2.014) were significantly associated with Profile 2 (all P<0.05).

CONCLUSIONS: Significant heterogeneity exists in mental health literacy among nurses in tertiary general hospitals in Chongqing. Personal help-seeking experience, lack of professional training, and high-pressure work environments are key determinants of profile membership. Future interventions should move beyond a "one-size-fits-all" approach and adopt stratified strategies: for the "low cognition-moderate acceptance" group, emphasis should be placed on improving knowledge; for the "moderate cognition-low acceptance" group, anti-stigma interventions and cognitive burden reduction are needed; for the "high cognition-moderate acceptance" group, efforts should focus on enhancing humanistic reflection and psychological empowerment. Such tailored approaches may ultimately contribute to the development of a holistic nursing care system.