The findings pertained to the following themes bias

The findings pertained to the following themes; bias (focus of 5 studies), stigma (focus of 4 studies),
negative attitudes (focus of 3 studies), stereotyping (focus of 2 studies), empathy (focus of 3 studies), and
knowledge and skills deficits (focus of 3 studies) among healthcare providers, along with one study
measuring attitudes towards using EBP. Overall, decreases in negative attitudes, stigma, and bias, and an
increase in empathy were found in the studies that pertained to those topics. Only 1 study suggested an

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increase in stigma and stereotyping as it relates to social distancing of patients diagnosed with
schizophrenia. Two studies looked at rating scales or measures to determine effectiveness of interventions
to increase empathy and decrease negative attitudes and bias, while one rated a scale to determine attitudes
toward the use of EBP. The theoretical frameworks were identified accordingly; 7 articles utilized
Bandura’s Self - efficacy Model, 2 used Wagner’s Chronic Care Model, and 1 used Meyer’s Minority
Stress Model.
The studies relied on questionnaires, pre- post-tests, empathy scales, narrative synthesis, structured
engagement, and specifically the Likert scale, Kuger & Casey Qualitative Analysis, and the Implicit
Association Test (Appendix A). ANOVA, MANOVA, Chi-Square tests, paired t-tests, Mann-Whitney U
test, Wilcoxon Signed-Rank Test, Bart lett’s test of Sphericity, Chronbach’s Alpha test, Confidence
Intervals, and Inter-Rater Reliability were all utilized in the studies.
We can conclude that educational interventions to create awareness of psychiatric etiology, pathology
and treatment modalities do have a positive impact on stigma and empathy. The research describes real-
time changes of decreased stigma and increased empathy and confidence on the part of nurses following
educational programs. Measures exist that can accurately assess stigma and empathy. These measures not
only provide proof of bias, they validate the success of interventions based on positive results. Educational
interventions to help nurses understand a psychiatric patient’s experience has empowered nurses to
provide care with increased confidence and understanding, thereby decreasing stigma and increasing
empathy.
Purpose Statement
Psychiatric patients in crisis are utilizing EDs at an increasing rate. The nurses they encounter are
faced with delivering treatment that is based on knowledge the nurses feel they lack, and understanding
and empathy the nurses struggle to conceptualize. The purpose of this paper was to determine if educating

DECREASING STIGMA AND IMPROVING THERAPEUTIC 14
ER nurses on the etiology and pathology of psychiatric symptoms, treatment modalities, along with the
positive effects of empathy, would affect nurse stigma and empathy towards the mentally ill.