Journal List > J Korean Acad Nurs > v.47(1) > 1003255

TOOLS
Joung, Jang, Shim, Ko, and Shin: Difficulties in Caring for Psychiatric Patient as Experienced by Non-Psychiatric Nurses
Original Article

Journal of Korean Academy of Nursing 2017; 47(1): 49-59.

Published online: 28 February 2017

DOI: https://doi.org/10.4040/jkan.2017.47.1.49

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

Jaewon Joung1, Mi Young Jang1, 2, Jihyun Shim1, Yoonhi Ko1, Sung Hee Shin2

1Department of Nursing, Kyung Hee University Medical Center, Seoul, Korea.

2College of Nursing Science and East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea.

Address reprint requests to: Shin, Sung Hee. College of Nursing Science and East-West Nursing Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. Tel: +82-2-961-0917, Fax: +82-2-961-9398, sunghshin@khu.ac.kr

Received 25 January 2016       Revised 19 September 2016       Accepted 4 November 2016

© 2017 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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.

Keywords: Qualitative research, Psychiatric nursing, Patients, Medical-surgical nursing, Mental disorders

Figures and Tables

Table 1

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

jkan-47-49-i001
Categories Subcategories Codes
Nurse related Unpreparedness Lack of knowledge in psychiatric nursing
Lack of experience in psychiatric nursing
Nursing barriers due to stigma Prejudice
Feeling overwhelmed (burdened)
Feeling anxiety and fear
Undervaluing and avoidance of psychiatric nursing Report only to the doctor
Deprioritized in the care plan
Recognizing physical care as complete nursing care
Feeling more comfortable at work
Eroding into the trap of a vicious cycle Feeling helplessness
Feeling guilty
Patient related Facing unapproachable patients Patients' self-harming or harming others
Highly demanding patients
Patients with erratic behaviors
Sensitive patients
Patients exerting harmful influence on other patients around
Dealing with unhelpful family members Families interfering with treatments
Families with mental disorders
Resource related Burdening already overburdened staff Taking care of many patients (or high patient-nurse ratio)
Work paralysis due to disruptive patients
Obstructive environment No treatment program
No consulting room
Hampered patient observation
No acting code for psychiatric nursing
Isolation of staff with heavy responsibilities Lack of patient safety system
Lack of referral system
Lack of training system

Notes

CONFLICTS OF INTEREST The authors declared no conflict of interest.

References

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.
TOOLS
Similar articles