Knowledge and Attitudes Toward Electroconvulsive Therapy Among Health Care Professionals and Students

Abstract

Widespread variations in electroconvulsive therapy (ECT) prescription between and within countries have led many researchers to study professionals' attitudes to the procedure. A questionnaire looking at knowledge and attitudes was administered to 593 medical and nursing students, psychiatrists and anesthetists, and theater and psychiatric nurses. Respondents were based in 2 Irish cities, Dublin and Cork. Poorer knowledge of ECT was found in the nursing group, and this included psychiatric nurses: a third overestimate ECT mortality, most did not know if it caused permanent brain damage, and only 1 psychiatric nurse (2.9%) expressed positive attitudes to its use. Nursing students had significantly lower knowledge and more negative attitudes than medical students, and exposure to the procedure of ECT failed to improve their attitudes. The strongest predictor of better knowledge and more positive ECT attitudes was membership of the medical group. There were direct associations between better knowledge and more positive attitudes in the medical group but not among the nursing group. Low ECT knowledge among psychiatric nurses has implications in obtaining patients' valid consent. Our failure to link exposure to ECT to better nursing attitudes is discussed along with other educational lessons.

Medical Students’ Perceptions of Electroconvulsive Therapy

“…2,8 This effect has been seen in medical students, but not consistently in students from other professions. 1 Participants' perceptions of other treatment modalities generally did not change significantly between the first and second surveys. This may reflect the fact that most students had no exposure to these modalities during the clerkship.…”

“…In 1 study, most psychiatric nurses surveyed had negative opinions regarding ECT. 1 In a survey of medical graduates and postgraduates, more than half believed that ECT causes brain damage, impairs thinking and reasoning, and is painful and unsafe. In addition, more than 20% believed that ECT is cruel, punitive, or misused.…”

“…5,7 However, when assessed directly, improved knowledge about ECT has been associated with more positive attitudes toward it among medical students and doctors. 1 Exposure to ECT is likely important in improving medical students' knowledge of and comfort level with this procedure. In at least 1 study, medical students exposed to ECT have proven to be more knowledgeable regarding this treatment modality than those who have not.…”

“…In at least 1 study, medical students exposed to ECT have proven to be more knowledgeable regarding this treatment modality than those who have not. 1 In a cross-cultural study examining the perceptions of ECT by medical students in the United Kingdom, Egypt, and Iraq, students from the United Kingdom were significantly more likely to have been exposed to ECT. 8 Medical students from the United Kingdom in general also had more positive attitudes toward ECT than their counterparts in Iraq and Egypt.…”

The impact of a "Brief ECT Orientation Module" on the knowledge and attitudes of medical students towards ECT in India

“…[35] In an Irish study, 39% of medical students linked ECT to brain damage. [36] A multinational study reported the theoretical knowledge of the Iraqi students to be better than that of both the United Kingdom and Egyptian students. [37]…”