J Korean Acad Nurs.  2017 Feb;47(1):49-59. 10.4040/jkan.2017.47.1.49.

Difficulties in Caring for Psychiatric Patient as Experienced by Non-Psychiatric Nurses

• Joung J
• Jang MY
• Shim J
• Ko Y
• Shin SH

• KMID: 2425936
• DOI: http://doi.org/10.4040/jkan.2017.47.1.49

Abstract

PURPOSE
The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness.
METHODS
Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.
RESULTS
General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were "˜nurse' related factors, "˜patient' related factors, "˜resource' related factors. The nine categories were "˜unpreparedness', "˜nursing barriers due to stigma', "˜undervaluing and avoidance of psychiatric nursing', "˜eroding into the trap of a vicious cycle', "˜facing unapproachable patients', "˜dealing with unhelpful family members', "˜burdening already overburdened staff', "˜obstructive environment', and "˜isolation of staff with heavy responsibilities'.
CONCLUSION
The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

Keyword

Qualitative research; Psychiatric nursing; Patients; Medical-surgical nursing; Mental disorders

MeSH Terms

Attitude of Health Personnel
Female
Focus Groups
Hospitals, University
Humans
Interviews as Topic
Male
Mental Disorders/diagnosis/*nursing
Nurse-Patient Relations
Nursing Staff, Hospital/*psychology
*Psychiatric Nursing
Surveys and Questionnaires

Reference

1. Leucht S, Burkard T, Henderson J, Maj M, Sartorius N. Physical illness and schizophrenia: A review of the literature. Acta Psychiatr Scand. 2007; 116(5):317–333. DOI: 10.1111/j.1600-0447.2007.01095.x.

2. Blythe J, White J. Role of the mental health nurse towards physical health care in serious mental illness: An integrative review of 10 years of UK literature. Int J Ment Health Nurs. 2012; 21(3):193–201. DOI: 10.1111/j.1447-0349.2011.00792.x.

3. Jones DR, Macias C, Barreira PJ, Fisher WH, Hargreaves WA, Harding CM. Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness. Psychiatr Serv. 2004; 55(11):1250–1257. DOI: 10.1176/appi.ps.55.11.1250.

4. Zolnierek CD, Clingerman EM. A medical-surgical nurse’ s perceptions of caring for a person with severe mental illness. J Am Psychiatr Nurses Assoc. 2012; 18(4):226–235. DOI: 10.1177/1078390312446223.

5. Carney CP, Jones L, Woolson RF. Medical comorbidity in women and men with schizophrenia: A population-based controlled study. J Gen Intern Med. 2006; 21(11):1133–1137. DOI: 10.1111/j.1525-1497.2006.00563.x.

6. An HR. Attitude on mental illness, perception on mental symptom, stress on mental health care, and expectation of psychiatric nurse's roles of non-psychiatric nurses in general hospitals [master's thesis]. Seoul: The Catholic University of Korea;2013. 1–49.

7. Kim BJ. A study on psychiatric nurses and non-psychiatic nurses' attitudes toward mental illness & the mentally ill [master's thesis]. Seoul: Ewha Womans University;2004. 1–63.

8. Lee TG, Kim JG. A study concerning the psychopathology and psychiatric consultaion of medical outpatients: Focused on medical outpatients compared with health control group. J Korean Neuropsychiatr Assoc. 2003; 42(6):755–760.

9. Yu SJ, Kim SYJ, Kim YH, Won JS, Lee KJ, Lee SW. Introduction to psychiatric nursing. Seoul: Soomoonsa;1983. p. 146.

10. Liggins J, Hatcher S. Stigma toward the mentally ill in the general hospital: A qualitative study. Gen Hosp Psychiatry. 2005; 27(5):359–364. DOI: 10.1016/j.genhosppsych.2005.05.006.

11. Zolnierek CD. Non-psychiatric hospitalization of people with mental illness: Systematic review. J Adv Nurs. 2009; 65(8):1570–1583. DOI: 10.1111/j.1365-2648.2009.05044.x.

12. Reed F, Fitzgerald L. The mixed attitudes of nurse’s to caring for people with mental illness in a rural general hospital. Int J Ment Health Nurs. 2005; 14(4):249–257. DOI: 10.1111/j.1440-0979.2005.00389.x.

13. Morgan DL. Focus groups. Ann Rev Sociol. 1996; 22:129–152. DOI: 10.1146/annurev.soc.22.1.129.

14. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277–1288. DOI: 10.1177/1049732305276687.

15. Sandelowski M. The problem of rigor in qualitative research. ANS Adv Nurs Sci. 1986; 8(3):27–37.

16. Haddad M, Plummer S, Taverner A, Gray R, Lee S, Payne F, et al. District nurses' involvement and attitudes to mental health problems: A three-area cross-sectional study. J Clin Nurs. 2005; 14(8):976–985. DOI: 10.1111/j.1365-2702.2005.01196.x.

17. Giandinoto JA, Edward KL. The phenomenon of co-morbid physical and mental illness in acute medical care: The lived experience of Australian health professionals. BMC Res Notes. 2015; 8:295. DOI: 10.1186/s13104-015-1264-z.

18. Ramritu P, Courtney M, Stanley T, Finlayson K. Experiences of the generalist nurse caring for adolescents with mental health problems. J Child Health Care. 2002; 6(4):229–244. DOI: 10.1177/136749350200600401.

19. Goncalves DA, Fortes S, Campos M, Ballester D, Portugal FB, Tófoli LF, et al. Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: A pre- and posttest study. Gen Hosp Psychiatry. 2013; 35(3):304–308. DOI: 10.1016/j.genhosppsych.2013.01.003.

20. Hundertmark J. The impact of mainstreaming on patient care in Australian emergency departments and liaison services. Aust N Z J Psychiatry. 2002; 36(3):424. DOI: 10.1046/j.1440-1614.2001.01030.x.

21. Sharrock J, Happell B. The psychiatric consultation-liaison nurse: Thriving in a general hospital setting. Int J Ment Health Nurs. 2002; 11(1):24–33. DOI: 10.1046/j.1440-0979.2002.00205.x.