1. INTRODUCTION:

Inadequate knowledge and conflicting attitudes toward people with disability were prevalent among health care professional in general and among nurses in specific. (Tervo et al, 2004; Au and Man, 2006; Mantziou et al, 2009; Rao et al, 2009). Past and current research demonstrates that very little time is devoted specifically to the issue of nursing attitude toward disabled patient, mental disabled patient in specific (Seccombe, 2007; Schoen et al, 2009). Nurses specially the associate degree graduate are the primary health care providers for patients with mental disabilities. Improving the future nurses’ willingness to work with mentally disabled patients may aid in the quality of care provided for people with mental disabilities, which may assist in preventing the deterioration and help empowering the mentally disabled people, which might help them to be more independent persons (Seccombe, 2007).

The undergraduate associate nursing students’ curriculum at Al-Balqaa Applied University in Jordan is covered over a two-year period. Advanced nursing course is the final undergraduate course; it’s a preceptor ship course, where the nursing students allowed to choose independently up to their willing to re practice in one of the nursing specialty areas which include maternal and child health care, adult health care, community health care and mental health care (forty - eight hours shifts).

A willingness is the mental activity that enables one to consciously choose or decide on a course of action (Medical-dictionary). Faculty member recognized that over the past three years the number of the nursing students who choose or decide to re practice in the mental health care area to fulfill the requirement of the advanced nursing course had been dramatically declined. It is anticipated that the decline in the nursing students number who are willing to work in the mental health care area will continue, with the increased number of the mentally disabled patients all over the world, this area will suffer a shortage in the nursing graduates who choose to work with mentally disabled patients. The importance of college's and university's-community interaction activities and initiatives is well recognized and established (Tenhouse,2014). These activities exist to complement the colleges and universities academic curriculum and to augment the students educational experience. This engagement role is thought to be key to sustainable economic development, as universities combine technology transfer and classroom learning with active involvement in sustainability projects on and off campus (Stephens et al., 2008).

So, in order to improve the willingness of the nursing students to work with mentally disabled patient, college – community interaction activity was initiated by the faculty member of the nursing student in collaboration with the clinical placement staff and administrators. Nursing school faculty thought that, providing the nursing students with positive contact opportunities with the mentally disabled patients will improve the nursing students willingness to work with mentally disabled patients, which may aid in the quality of care provided for the mentally disabled patients, as will as recognizing the merit of the collaborative health team effort, and can be used to fulfill the requirements of the nursing students curriculum objectives. Therefore, this study evaluated an college – community interaction initiative carried out to improve the nursing students willingness to work with mentally disabled patients in mental health care institution, and hypothesized that: Willingness of the nursing students to work with mentally disabled patients significantly improved after their participation in the college – community interaction initiative as clarified from the number of students who chose to re practice in the mental health care area after previous refusal. Specific demographic variables such as age, gender, family history of mental illness, have an effect on the willingness of the participants to work with mentally disabled patients in mental health care institution.

2. THEORETICAL FRAMEWORK:

The primary conceptual framework utilized for the planning, implementation and evaluation of the college – community interaction initiative was based on the PRECEDE-PROCEED model (Green and Kreuter, 2005). PRECEDE is an acronym that stands for predisposing, reinforcing, and enabling constructs in education, diagnosis, and evaluation, while PROCEED is the second part of the conceptual model and involves four phases that are focused on implementation and evaluation . These processes work in unison with the PRECEDE phases facilitating the identification of priorities and the setting of objectives, while the PROCEDE phases assist in identifying the criteria for policy implementation and subsequent evaluation (Green and Kreuter, 2005). A major strength of this Model is its capacity to facilitate identification of the desired outcomes at the outset of the planning process, which determines the evaluation metrics. This Model also aids systematic classification of factors by their relative importance and capacity for modification through the use of a ranking system (Green and Kreuter, 2005). A ranking system facilitates consideration of the determinants for change at individual, provider, and system levels and allows for the identification, development, and implementation of interventions with the greatest potential of achieving a positive impact. Whereas the main purpose of the initiative program was to improve the willingness of the nursing students to work with mentally disabled clients, the PRECEDE-PROCEED model in this study helped to assess the predisposing, enabling, and reinforcing factors which affect the willingness of the nursing students to work with mentally disabled client and areas where improvement could be made, plan group of interventions, implement, and evaluate the effect of the college – community interaction initiative in improving the willingness of the nursing students to work with mentally disabled clients. The most fundamental assumption of the model is the active participation of its intended audience-that is, the participants will take an active part in defining their own problems, establishing their goals, and developing their solutions (Green and Kreuter, 2005). Model usefulness had been demonstrated in health field through international researchers (McAuliffe, 2007;Meador , 2006; Moand Mak, 2008; Wang S, Wang R, 2000).

However, the framework was not used as a step-by-step guide. Rather, the desired outcomes were identified and work backwards in the causal chain to identify mix strategies for achieving objectives.

3. METHOD:

3.1 Study hypotheses

Although the main purpose of the college – community interaction initiative was to improve the willingness of the nursing students to work with mentally disabled patient in the mental health care institutions, the specific objective of this study was to evaluate the effect of the college – community interaction initiative on the willingness of the nursing students to work with mentally disabled patient, and hypothesized that:

1. Nursing students’ willingness to work with mentally disabled patient significantly improved after their participation in the college – community interaction initiative as clarified from the number of students who chose to practice in the mental health care area after previous refusal.

2. Nursing students’ demographical variables as age, gender, family history of mental illness, has an effect on the willingness of the nursing students to work with mentally disabled patients in the mental health care institutions.

3. Nursing students had positive reaction toward the college - community interaction initiative program as indicated by a survey data completed by them in order to determine their satisfaction of the initiative program components.

3.2 Study design

Descriptive design (Polit and Beck, 2012) were utilized. Mixed method approach was selected including focus group discussion and a student’s survey to assess for the student’s willingness to work with mentally disabled patients. The use of both quantitative and qualitative methods of data collection in order to assist in understanding the complexities of health care trends and issues, the advantages of the mixed method approach and how it could accommodate the disadvantages of individual method had been highlighted by (Andrew and Halcomb, 2009).

3.3 Population

The eligible population for this study was 60 nursing students booked in two classes of the advanced nursing course, 42 students were female and 18 students were male. One faculty member (researcher) was responsible for the students in fulfilling both the theoretical and clinical course requirements.

3.4 Sample

Convenience sampling procedure was used to obtain the larger sample. Undergraduate nursing students in their last pre-graduate semester, after they pass the mental health care course, voluntarily had the opportunity to participate in the initiative program, as a college – community interaction activity. 48 nursing students committed completely to the initiative program, 36 students were female and 12 students were male participated in the study. The average age of the participants was 20 years (SD = 3.2), and their academic average was 65% (SD = 8.5).

3.5 Setting

This study was conducted at Al-Balqaa Applied University- Zarqa College - an applied science college -, in the middle of Jordan, with an approximate total enrolment of 3500 students.

3.6 Data Collection

3. 6. 1 Qualitative data collection

Qualitative data collected through analyzing focus group discussion manuscripts. The focus group discussion as a strategy to describe the participants experiences (Parker and Tritter, 2006), and to capture their concerns had been emphasized (Krueger and Casey, 2000) . Issues and concerns rose by authors about the extent to which pervasive exercise of power that may be inherent within focus group discussion ( Karau and Jason, 1998; Kitchenham,2008; Lattimore and Glinow, 2010).

To overcome some disadvantages of the focus group discussion which rose by authors as group interaction which may range from conformity to extreme behaviors (Silverman, 2001)., and the importance of the facilitator or moderator of the focus group discussion which had been emphasized by (Parker and Tritter, 2006), the researcher facilitates all the focus group discussions, discussions were taped and transcribed verbatim.

3. 6. 2 Quantitative data collection

3. 6. 2. i. Self – administered questionnaire was used: The willingness towards Mental Health Care Questionnaire. Likert-type scale which was developed by the researcher includes 10-items, looking at students cheerfully compliant to mental health care, These are: mentally disabled patients, and mental health care institutions (Appendix A). Each statement makes explicit a certain compliant towards the object. At the end of the questionnaire one item added to identify the participants’ suggestions of interdisciplinary collaboration. The scale was pilot-tested for clarity of presentation and content among a random population of nursing students not participating in the initiative program. The validity and reliability of the scale has been confirmed through a group of experts and a test – retest approach, internal reliability for the total scale was 0. 84. The alpha coefficient was 0. 82.

3. 6. 2. ii. Self report evaluation index: The index which was developed by the researcher includes 10- items prepared to determine the student’s perception of the usefulness of the activity program and students workers interaction. Student was asked to put on a continuum varies from 0-100% students opinion and view on the usefulness of the program to the participants in achieving the advanced nursing course objectives. Each question evaluates the participant satisfaction of one of the initiative program components. Index was pilot-tested for presentation and content among a random population of nursing students not participating in the initiative program (See Appendix D) for Students Satisfaction Index.

3.7Procedure

After the initiative program had reviewed and approved by Faculty of Nursing Research Comity. Nursing students at a pre planned meeting was informed, oriented, invited to participate, received the intervention plan (Appendix B), and asked to facilitate the intervention through their participation; their participation was one mean of fulfilling the advanced nursing course objectives - a pre-graduate nursing program requirement.

Informed consent was obtained. Participants’ confidentiality and anonymity were maintained by assigning random pseudonyms A, B, C, D and……….Z, which were written on the questionnaire form to enable linking the pre and post intervention scores. Potential participants were assured that they could withdraw without prejudice at any time. Pre-intervention a covering letter explain the purpose of the study followed by the demographic questionnaire were the potential participant’s indicated his/her age, total academic average, marital status, occupation, total income of the family, medical insurance, personal and family medical, surgical, mental and hereditary history. The willingness towards Mental Health Care Questionnaire was attached together to be filled at the same time.

3.7. 1 Focus group discussion

Potential participants were already oriented to focus group discussion and they practiced focus group discussion more than once as a teaching learning strategy.

To reduce the risk of coercion, provide a chance for every student to talk, and to provide diversity of opinion (Karau et al 1998, McShane et al 2010), participants were asked to independently divide into teams with six students in each team. To confirm the interpretation of data and captured non-verbal communications (Silverman 2001), team leader one of the nursing students was independently chosen by the team members.

Faculty member (researcher) facilitated all the focus group discussions, discussed with the participants how the focus group would operate and how findings would be collated, accessed only by the researcher, and used only for the research purpose. Participant was asked to consider Predisposing, enabling, and reinforcing factors which will improve their willingness to work with mentally disabled patient and areas where improvement could be made. Predisposing, factors include knowledge, attitudes, beliefs, personal preferences, existing skills, and self-efficacy towards the desired behavior change. Reinforcing factors include factors that reward or reinforce the desired behavior change, including social support, economic rewards, and changing social norms. Enabling factors are skills or physical factors such as availability and accessibility of resources or services that facilitate achievement of motivation to change behavior (Green and Kreuter, 2005).Focus group discussion was guided by the following questions:

You have considered not to re practice in the mental health care area to fulfill the requirement of the advanced nursing course. You have been oriented that we are here to discuss:

- What factors contributed to your decision not to re practice in the mental health care area?

- What suggestions do you have to improve the practice environment so that you would want to re practice in the mental health care area?

Probes for Discussion: Opportunity to achieve the nursing curriculum objectives; Management and supervision; Benefits; Safety and Health protection measures; Culture, inter-professional relationship, respect, recognition from administrators or others; Abuse issues in the area; Working conditions access to transportation, cafeterias, supplies; Standards of living; Inter-professional collaboration, educational workshops.

At the end of each discussion key ideas derived from the discussion were identified and verified by participants as a reasonable summary of the group discussion (Krueger and Casey, 2000). The college–community interaction initiative for the participants consisted of one day practice in one of the mental health care institutions. The program of the day arranged as college-community interaction activity. The schedule of the activity (Appendix C) were based on the information gained from the analysis of nursing students focus group discussion manuscripts, and the willingness towards mental Health care questionnaire, mental health care institution manager experience and the researchers experiences.

3.7. 2 Mental Health Care Institution Staff Collaboration

The mental health care institution manager was informed of the initiative program. The manager identified one of the college graduates to be our liaison with the institution staff. Collaboration with the initiative program was one means of fulfilling the staff roles, which served as an incentive for participation. Also participation of the nursing students in the initiative program was one means of fulfilling the advanced nursing course objectives - a required last-semester nursing program requirement, and served as an incentive for participation. All mental health care institution staff, and associate nursing students were informed, oriented, and received the initiative plan at a pre planned meeting, and were asked to facilitate the initiative program through their assigned work and practice.

3. 8 Data analysis

Data collection and initial analysis were undertaken concurrently. focus group manuscripts were verbatim analyzed using thematic analysis (Hsieh and Shannon, 2005). Conventional content analysis was used. The data were read, reread word by word with a focus on Predisposing, enabling, and reinforcing factors which effect the willingness of the participants to work with mentally disabled patient and areas where improvement could be made. To promoted consistency and resolve ambiguities and identify divergence and convergence of views, data were interpreted as a whole, and emergent themes in terms of Predisposing, enabling, and reinforcing factors which effect the willingness of the participants to work with mentally disabled patient and areas where improvement could be made were discussed with students team leaders. Memos were written regarding first impressions and thoughts emerging from the data. Initial themes were identified; organized and related codes were then collapsed into broader categories. These emergent categories were organized coded in a template based on the study hypotheses (Patton, 2002; Hsieh and Shannon, 2005; Creswell et al 2010).

Quantitative data collected through The willingness towards Mental Health Care Questionnaire and the self report satisfaction index were analyzed using descriptive and inferential statistics. All tests were two tailed unless otherwise stated with the results considered statistically significance if the p value is < 0.05.

4. RESULTS:

Initially 60 students participated in the college-community interaction initiative program. However 48 of these students were completed the participation requirement with a response rate of 80%, , 36 students were female and 12 students were male students. The first hypothesis of this study was Nursing students’ willingness to work with mentally disabled patient significantly improved after their participation in the college – community interaction initiative as clarified from the number of students who chose to practice in the mental health care area after previous refusal. This hypothesis was addressed by analyzing . The willingness towards Mental Health Care Questionnaire. To assured the clarity, the 'strongly. agree' response and 'agree' responses were combined as a single 'agree' response, and the 'strongly disagree' and 'disagree' combined into a 'disagree' response. Using the Wilcox on matched-pairs signed ranks test, statements showing significant change (p < 0.05) were identified. Statements that showed significant change in scores and the level of students' agreement before and after the attachment are shown in Table I. Significant increase in the number of the nursing student who chose to re practice in the mental health care institution as a first or second choice after previous refusal accepted as an indicator of improving the nursing students willingness to work with mentally disabled patients in mental health care institutions as a result of their participation in the college – community interaction initiative program. (P = 0.002), Participants who chose to be a mental health care worker also significantly increased after their participation in the college – community interaction initiative program (P=0.033).

The second hypothesis of this study was " Nursing students’ demographical variables as age, gender, family history of mental illness, has an effect on the willingness of the nursing students to work with mentally disabled patients in the mental health care institutions". There was no difference related to nursing students demographical variables as age, and gender. Regardless of the statistical tests used.

The third hypothesis of this study was " participants had positive reactions toward the college - community interaction initiative program as indicated by a survey data completed by them in order to determine their satisfaction of the initiative program components”. This hypothesis was addressed by reviewing and summarizing participant responses to participants’ reaction index survey. Overall, participants’ ratings of the initiative program components were 88%. On average, 90% of the respondents provided rating of 85-95% across all items. Means were calculated for each item. Results presented in Table II. show that students highly appreciated the transportation and lunch freely provided to them by the mental health care institution The least favorable component of the program as rated by respondents with a mean of 85% was the help and direction provided to them by their preceptors.

Table I: Individual items from the willingness towards Mental Health Care Questionnaire showing significant change (p < 0.05) as a result of participation in the college – community interaction initiative.

	Statement	Pre Participation		Post Participation		Z Value	Two Tailed P
	Statement	Agree	Disagree	Agree	Disagree	Z Value	Two Tailed P
1	Training in the mental health area is valuable.	62.5	12.5	81.1	2.1	2.769	0.006
2	Mental health care is a respected branch of health care.	66.7	10.4	81.3	8.4	2.430	0.015
3	Mental illness deserves at least as much attention as physical illness.	64.6	12.5	89.4	2.1	2908	0.004
4	Mental health care institutions (can help specifically in) the treatment of the mentally ill patients.	31.3	45.8	45.8	27.1	3.017	0.003
5	If we listen to them, mentally disabled patients are just human as other people.	55.3	4.3	76.6	4.3	2.895	0.004
6	Mentally ill patients are often more interesting to work with than other patients.	48.0	18.8	85.4	6.3	3.045	0.002
7	The practice in the mental health area allows the development of really rewarding relationships with people.	2.1	53.2	0.0	76.5	3.232	0.001
8	Care provided to the mentally ill patients is effective.	12.5	64.6	2.1	89.4	2.908	0.004
9	If I were asked what I considered to be the two most exciting specialties, mental health would be one of them.	0.0	79.1	12.5	41.7	3.045	0.002
10	I would like to be a mental health care worker.	25.1	60.5	47.9	43.8	2.129	0.033

Table II. Participants’ opinion and view on the value of each of the initiative program component

Component	Mean ( %)
Mental Health Institution Bus pass by and pick the scheduled students: Free transportation available to the participants (student).	100%
Orientation : Orient the scheduled students to the Mental Health Care Institution.	95%
Assignment: Assign the students to the working area, introduce them to assigned preceptors.	88%
Break and Lunch: Students permitted to receive their meals with the institutional workers.	100%
Shifting the student: Students will be shifted to another preferred area.	90%
Leaving time: Student returned back to college by institution bus.	100%
Supervision and directions provided to you from your preceptor	85%
Students and preceptors collaboration	88%
Students and institution workers interaction	90%
Achieving the advanced nursing course objectives	88%

5. DISCUSSION:

The results of this study were evaluated using the participants satisfaction of the training program. Participants ratings of the initiative program components and positive comments. The significant increase in the willingness of the nursing student to work in the mental health care area of practice provide evidence to the potential value of the initiative program components. The study found as clarified from the nursing students’ comments and reactions to the initiative program components that the initiative was beneficial for the nursing students as well as for the mental health institution patients and workers. The study findings support the findings and recommendations of international researchers emphasized what is known as universities third role in which universities actively engage in their communities beyond teaching and research, including engagement efforts ranging from neighborhood school reform, to staffing community health centers (Maurasse, 2001). This engagement role is thought to be key to sustainable economic development, as universities combine technology transfer and classroom learning with active involvement in sustainability projects on and off campus (Stephens et al., 2008).

6. CONCLUSION:

The work of this study was based on the assumption that “college– community interaction initiatives may help meeting the community needs and enrich the college students experience. Reaction of the participants and their positive comments indicate that the program provide a sensible benefit to the participants. Findings of this study can potentially provide valuable initial evidence about issues related to college – community interaction programs and initiatives which should be provided to community sectors.

Recognizing that the program does not represent any increase in the demands on the resources, In fact the program can have a beneficial effect for the staff as a part for achieving the incentives requirements, and for the nursing students through their practicing in order to achieve their learning objective in working as a change agent which is one of their curriculum objectives. Therefore, continuo in implementing the program as a continuous part of the college – community interaction collaborative activities after filling the prerequisites administrative agreement, and to include college students from other specialties' as special education program students, and physiotherapy. Further longitudinal follow up study to measure the sustainable benefit of the program on the nursing students could be done.

The limitations of the study include the small sample, the purposive convenience sample selection, and the self report surveys which could prohibit the generalization of the study findings.

Lastly, faculty members in nursing colleges need to consider way in which they might contribute to affect positive evidence based change in clinical settings.

7. ACKNOWLEDGEMENTS:

The author wishes to thanks the Mental health care institution manager, and health care workers, and the nursing students for their participation and collaboration in the initiative program.

8. REFERENCES:

Au, K.W and Man, D.W. Attitudes toward people with disabilities: a comparison between health care professionals and students. Int J Rehabil Res. 29(2); 2006:155-60. http://www.ncbi.nlm.nih.gov/pubmed/16609328 .

Green L, Kreuter M. Health program planning: An educational and ecological approach. New York : Mc Grawhill, 2005; 4^th ed.

Greene, J. C., and Caracelli, V. J. (1997). Defining and describing the paradigm issue in mixed method evaluation. New Directions for Evaluation, 74; 1997: 5-17. http://dx.doi.org/10.1002/ev.1068

Karau, S. J., and Jason, W. H. Group Cohesiveness and Social Loafing: Effects of a Social Interaction Manipulation on Individual Motivation within Groups. Group Dynamics: Theory, Research, and Practice. 2(3); 1998: 185-191. http://dx.doi.org/10.1037/1089-2699.2.3.185.

Kitchenham, A. The Evolution of John Mezirows Transformative Learning Theory. Journal of Transformative Education. 6 ;2008:104. http://dx.doi.org/10.1177/1541344608322678.

Krueger R and Casey M. A. Focus groups. A Practical Guide for Applied Research. London Sage Publication, London. 2000.

Lattimore, M. S., and Glinow, M. A. Organizational Behavior: Emerging Knowledge and Practice for the Real World. Boston: McGraw-Hill Irwin. 2010; 5^th ed. ISBN 9780073381237.

Mantaziou, V.; Brocalaki,I.; Andrea,S.; Ktenas,E.; Chatira,K. and Kotzabassaki,S. Attitudes of registered nurses and student nurses to disabled children. British Journal of Nursing. 11(17); 2002. Consulted 20 .09.2010 http://web.ebscohost.com/ehost/detail?vid=16andhid.

Maurasse, D. Beyond the Campus: How Colleges and Universities Form Partnerships with Their Communities. New York, Routledge. 2001.

McAuliffe A . Nursing students’ practice in providing oral hygiene for patients. Nursing Standard. 21(33); 2007: 35–39.

Meador MG, Linnan LA. Using the PRECEDE model to plan men’s health programs in a managed care setting. Health promotion practice. 7(2); 2006 :186–196.

Mo PKH, Mak WWS. (2008).Application of the PRECEDE model to understanding mental health promoting behaviors in Hong Kong. Health Education and Behavior. 35(4); 2008:574–587.

Medical-dictionary. The free dictionary.com.

Polit, D.F., Beck, C.T. Nursing Research: Generating and Assessing Evidence for Nursing Practice . Lippincott: Williams and Wilkins.2012; 9^th ed.

Rao, H.; Mahadevappa, H.; Pillay, P.; Sessay, M.; Abraham ,A. and Luty, J. A study of stigmatized attitudes towards people with mental health problems among health professionals. Journal of Psychiatric and Mental Health Nursing. 16; 2009: 279–284.

Schoen, B.; Shannon, C.D. and Tansey, T.N. The Effect of Contact, Context, and Social Power on Undergraduate Attitudes Toward Persons with Disabilities. Journal of Rehabilitation. 75( 4);2009: 1118. http://www.sciencedirect.com.ezproxy.turkuamk.fi/science.

Seccombe,J.A .Attitudes towards disability in an undergraduate nursing curriculum: The effects of a curriculum change. Nurse Education Today. 27; 2007: 459–465.

Silverman, D. Interpreting qualitative data: Methods for analysing talk, text, and interaction. London: Sage. 2001; 2^nd ed.

Stephens, J. C., Hernandes, M. E., Roman, M., Graham, A. C. and Scholz, R. W. Higher Education as a Change Agent for Sustainability in Different Cultures and Contexts. International Journal of Sustainability in Higher Education. 9; 2008: 317-338.

Tenhouse, A. M. College Extracurricular Activities - Impact on Students, Types of Extracurricular Activities . [Online] Available: http://education.stateuniversity.com/pages/1855.

Tervo, R.C.; Palmer, G. and Redinius, P. Health professional student attitudes towards people with disability. Clinical Rehabilitation. 18; 2004: 908-915. Consulted 20.09.2010 http://www.sciencedirect.com.ezproxy.turkuamk.fi/science.

Wang S, Wang R. Using the PRECEDE model to predict AIDS preventive intentions of junior college students. Nursing Research. 8(3); 2000:349–361.

Appendix A-

The willingness towards Mental Health Care Questionnaire.

Please answer the following questions that relate to your opinion with each component of the Questionnaires

	Statement	Strongly agree	Agree	Neutral ( no opinion)	Disagree	Strongly Disagree
1	Training in the mental health area is valuable.
2	Mental health care is a respected branch of health care.
3	Mental illness deserves at least as much attention as physical illness.
4	Mental health care institutions (can help specifically in) the treatment of the mentally ill patients.
5	If we listen to them, mentally disabled patients are just human as other people.
6	Mentally ill patients are often more interesting to work with than other patients.
7	The practice in the mental health area allows the development of really rewarding relationships with people.
8	Care provided to the mentally ill patients is effective.
9	If I were asked what I considered to be the two most exciting specialties, mental health would be one of them.
10	I would like to be a mental health care worker.

· If I were asked what I considered to be the four most college specialties graduates suits to care for mentally disabled patients, I would suggest the:

Appendix B-

Intervention plan

Step		Content	Coordinator and Facilitators
1	Orientation	Orient the participants to the initiative plan. Fill the willingness towards Mental Health Care Questionnaire ( Pre intervention) and Demographical data	Researcher (faculty member)
2	Focus group Discussions	Identify Predisposing, enabling, and reinforcing factors which effect the willingness of the participants to work with mentally disabled patient and areas where improvement could be made.	Researcher Students team leaders
3	Meeting the Mental Health Institution Manager and staff	Discuss the Focus group discussion results, plan to facilitate the positive identified factors, and to fill the identified gaps.	Researcher Mental Health Institution Manager and the assigned staff
4	Develop the activity plan	Activity plan and final schedule	Researcher Mental Health Institution Manager and the assigned staff
5	Implement the Activity	Implementing the activity plan	Researcher Mental Health Institution Manager the assigned staff and the participants
6	Evaluation	Participant Evaluate the activity plan, and Refill the willingness towards Mental Health Care Questionnaire ( Pre intervention)	Researcher
7	Feedback and Appreciations	Inform the participants, Mental Health Institution Manager ,and the assigned staff about the final evaluation and the post intervention survey results. Appreciate their effort and participation	Researcher

Appendix C-

Activity Schedule

Step and Time		Content	Coordinator and Facilitators
1. 7-7.10 am	Mental Health Institution Bus pass by and pick the scheduled students	Free transportation available to the participants (student)	Researcher, Mental Health Institution Manager, Student assigned team leader and bus Driver
2. 7.30-8am	Orientation assignment	Orient the scheduled students to the Mental Health Care Institution	Assigned liaison staff
3. 8am -12 md	Assignment	Assign the students to the working area, introduce them to assigned preceptors	Assigned liaison staff
4. 12md-1pm	Break and Lunch	Students permitted to receive their meals with the institutional workers	Mental Health Institution Manager, Assigned liaison staff, and preceptors
5. 1pm -5pm	Shifting the student	Students will be shifted to another preferred area	Assigned liaison staff, and preceptors
6. 5pm	Leaving time	Student returned back to college by institution bus	Assigned liaison staff and bus Driver

*Participants permitted to practice 4 hours with the physically ill patients.

** The other 4 hours students permitted to choose to look after the patient in one of the play therapy or Music therapy area.

Appendix D-

Student’s Satisfaction Index

Component	Satisfaction rate %
Mental Health Institution Bus pass by and pick the scheduled students: Free transportation available to the participants (student).	0……………………………100%
Orientation : Orient the scheduled students to the Mental Health Care Institution.	0……………………………100%
Assignment: Assign the students to the working area, introduce them to assigned preceptors.	0……………………………100%
Break and Lunch: Students permitted to receive their meals with the institutional workers.	0……………………………100%
Shifting the student: Students will be shifted to another preferred area.	0……………………………100%
Leaving time: Student returned back to college by institution bus.	0……………………………100%
Supervision and directions provided to you from your preceptor	0……………………………100%
Students and preceptors collaboration	0……………………………100%
Students and institution workers interaction	0……………………………100%
Achieving the advanced nursing course objectives	0……………………………100%

· Other comments write it down here please………………………………………………………………………………………………

Received on 25.08.2014 Modified on 10.09.2014

Asian J. Nur. Edu. and Research 5(1): Jan.-March 2015; Page 50-57

DOI: 10.5958/2349-2996.2015.00012.9