Author ORCID Identifier


Date of Award

Summer 8-8-2023

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Dr. Kathleen M. Baggett

Second Advisor

Dr. Betsy Davis

Third Advisor

Dr. Collins O. Airhihenbuwa


Introduction: Rural Primary Health Care (PHC) nurses in post-war settings experience mental health problems resulting from traumatic exposures. They also experience burnout and compassion fatigue caring for high number of patients with untreated mental health problems due to cultural practices that promote stigma, and lack of adequate mental health services. Social stigma is society’s negative perceptions of an individual with mental illness, viewing them as socially unacceptable. The purpose of the study is to provide foundational understanding to inform future development of anti-stigma interventions PHC in rural northern Uganda. Research questions included;(1) What percentage of PHC nurses have personal experience with mental health disorders? (2) How do knowledge of and beliefs about mental health relate to mental health attitudes of PHC nurses in rural northern Uganda? (3) Do personal experiences with mental illness moderate the relations between knowledge, beliefs, and mental health related attitudes? (4) Following through with findings from research questions 2 and 3, do the mental health attitudes of nurses, explained by their knowledge and beliefs about mental illness and moderated by their personal experience with mental illness, relate to nurses’ future intended behavior with individuals suffering with mental illness?

Methods. To address these research questions, an existing data set of 65 nurse participants that captured stigma measures was used to conduct secondary analysis. In addition to original study variables (attitude, reported future intended behavior, age and sex), new variables of interest were constructed. These included: personal experience with mental illness derived from a 12 item Level of Contact Report (Corrigan et al., 2001), knowledge about common mental disorders and beliefs about mental health both derived from the Mental health Knowledge Schedule (MAKS; Evans-Lacko, et al., 2010). SPSS version 28 was used to generate descriptive statistics and conduct linear regression modelling to answer the research questions.

Results: More than a quarter of the study participants (28%) had personal experience with mental illness. Beliefs about mental illness explained significant variance in nurses’ benevolence attitude (β=.755, R2=.135, p=.003), with higher levels of positive beliefs about mental illness being related to higher levels of benevolence attitudes. The interaction of knowledge x beliefs explained significant variance in social restrictiveness attitude (β=-.146, R2=.122, p=.022), with higher levels of knowledge interacting with higher levels of positive beliefs being related to lower levels of social restrictiveness attitudes. Personal experience with mental illness moderated the relationship between combined knowledge of and beliefs about mental illness and social restrictiveness attitudes (β=.070, p

Conclusion: To better address nurses’ mental health needs and to counter mental health stigma in rural Uganda, future rigorous studies, which employ sensitive measures of nurses’ personal experience, mental health beliefs, and cultural practices are needed. Future studies should also explore nurses’ mental health needs and innovative ways of addressing their mental health needs in the rural setting.


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