Bridging Critical Care and Mental Health: Jordanian ICU Nurses' Self-Reported Knowledge, Skills, Attitudes and Confidence in Caring for Patients With Mental Illness.

BACKGROUND

Intensive Care Unit (ICU) nurses frequently care for patients with mental illness, yet many report feeling insufficiently prepared to address mental health needs in critical care settings. Understanding nurses' knowledge, skills and attitudes toward mental health care is essential to improving the quality and safety of care.

AIM: This study assessed Jordanian ICU nurses' self-reported knowledge, skills and attitudes regarding the care of patients with mental illness and examined factors associated with their perceived competence in managing mental health conditions in critical care settings.

METHODS

A cross-sectional descriptive design was used, involving 502 ICU nurses from 20 public, private and university hospitals in Jordan. The primary outcomes were nurses' self-reported perceived knowledge and preparedness, self-reported skills and attitudes toward caring for patients with mental illness. The questionnaire also assessed previous experience and receipt of formal training specifically related to mental health care for critically ill patients. Data were analysed using descriptive statistics, Kruskal-Wallis test, Pearson correlations and multiple regression. Instrument reliability was acceptable (Cronbach's α = 0.81-0.92).

RESULTS

Nurses reported moderate self-reported perceived knowledge and beliefs (mean = 3.19 ± 0.70), self-reported skills (mean = 3.20 ± 0.51) and attitudes (mean = 3.28 ± 0.44). Important gaps were identified in knowledge of psychotropic medication use, clinical assessment tools and legal aspects of mental health care, as well as confidence in managing suicidal behaviour, psychotic symptoms and mental status assessment. Only 32% of nurses had received formal training specifically in mental health care for critically ill patients, whereas 79% reported that they could be better prepared to manage such situations with additional education. Perceived knowledge-and-beliefs scores, skills and attitudes were strongly and positively correlated (r = 0.606-0.790, p < 0.001). Higher educational qualification (β = 0.129, p = 0.011) and longer professional nursing experience (β = 0.229, p = 0.005) were associated with higher self-reported skills. More positive attitudes were associated with educational qualification (β = 0.174, p < 0.001), years as a qualified nurse (β = 0.362, p < 0.001) and ICU experience (β = 0.211, p < 0.001).

CONCLUSION

Jordanian ICU nurses reported moderate perceived competence in mental health care, alongside important gaps in perceived knowledge, perceived preparedness, self-reported clinical assessment skills and confidence in managing complex mental health situations. Some responses also indicated potentially stigmatizing beliefs that require attention in future education. The strong associations among knowledge, skills and attitudes suggest that these domains should be addressed together through structured mental health education, practical skills training and organizational support. Objective assessment of clinical competence is warranted to complement self-reported preparedness.