Factors influencing career preference in mental health among nursing students and intern nurses in Dar es Salaam, Tanzania

Abstract

Worldwide, the prevalence of mental health, neurological, and substance use (MNS) disorders has been on the rise and remains a significant leading cause of disease burden. Sub-Saharan Africa (SSA) shares a fair burden of MNS with depressive disorders being the most prevalent in this region. A huge treatment gap for MNS exists, with lack of appropriate human resources and expertise for service delivery being one of the key barriers. Pre-service and in-service training plays a vital role in developing human resource for mental health. However, low or lack of career interests in mental health has been documented among students. A cross-sectional study was conducted between April and May 2021 to determine factors influencing career preference in mental health among nursing students and intern nurses at Muhimbili University of Health and Allied Sciences (MUHAS) and Muhimbili National Hospital (MNH) respectively in Dar es Salaam, Tanzania. Sixty-eight (68) nursing students at MUHAS who had covered the mental health nursing course and 83 intern nurses who had rotated at the MNH Psychiatry and Mental Health department participated in the study using consecutive sampling. A pre-tested structured self-administered questionnaire was used to collect data, followed by analysis with version 25 of the Statistical Package for the Social Sciences. The Chi-square test and logistic regression were performed to determine factors associated with career preference. One third (33.1%; n = 50) of participants had career preference in mental health nursing. Living with a person with mental illness (adjusted odds ratio [AOR]: 4.350; 95% CI: 1.958, 9.664; p <0.001), awareness of possible career advancement in mental health (AOR: 16.193; 95% CI: 2.022, 129.653; p = 0.009), awareness of possible income generation in mental health career (AOR: 6.783; 95% CI: 2.295, 20.047; p = 0.001), and satisfaction with psychiatric working environment (AOR: 6.753; 95% CI: 2.900, 15.726; p <0.001), were significantly associated with career preference in mental health. Low mental health career preference among university nursing students and intern nurses jeopardizes the future of the mental health nursing profession and may complicate the already existing shortage of human resource for mental health. The higher learning institutions, health facilities, and the Ministry of Health may need to take deliberate actions to ensure that interest to pursue a career in mental health is built among students and interns. Further research is needed to provide more insight into how the psychiatric working environment affects career preference in mental health.