Psychiatric mental health nurses (PMHNs) are responsible for assessing the mental health needs of individuals and developing a nursing diagnosis and plan of care. While PMHNs usually implement nursing processes relevant to the patients’ needs, advanced practice registered nurses in psychiatric care can also prescribe medicine and conduct psychotherapy. According to a study by Marks, Hallam, Philpott, and Connolly (1975), PMHNs who were trained in behavioral psychotherapy for neurotic disorders proved to be as effective as psychologists and psychiatrists working in the field. Although the nurses’ effectiveness in providing treatment has been confirmed, the experiences of patients who received treatment from PMHNs have not been investigated thoroughly. The purpose of this study will be to describe the experiences of adult patients with mood disorders who received psychotherapy interventions provided by PMHNs.
While quantitative studies are important to measure the outcomes of interventions as accurately as possible, quantitative studies alone do not help researchers and healthcare providers understand the experiences and needs of their patients. Therefore, qualitative studies are important to build emotional rapport and improve communication with patients in psychiatric care. However, most qualitative studies addressing the experiences of psychiatric patients focus on areas such as (1) patient perceptions of relationships with mental health providers (Schroeder, 2013), (2) patient experiences in acute inpatient psychiatric units (Thibeault, Trudeau, d’Entremont, & Brown, 2010), (3) psychosocial care nurses’ experiences in palliative care (Arving & Holmström, 2011), and (4) psychiatric nurses’ experiences in therapeutic relationships with mentally ill patients (Poggenpoel, Myburgh, & Morare, 2011; Hawamdeh & Fakhry, 2013). The literature has extensively covered the nurses’ experiences in psychiatric care, so it is also important to investigate the patients’ perspectives to understand their needs and feelings better and improve care delivery accordingly.
Methods
Study Design
The qualitative research method will be used for this research because qualitative methods are better suited for investigating personal experiences than quantitative methods. The study will use the descriptive phenomenology framework because it uses the concept of bracketing to eliminate the researcher’s personal beliefs and feelings that can cause bias during data analysis (Balls, 2008). Therefore, the interference of presuppositions and preconceptions will be minimized to analyze the data objectively. Because the purpose of phenomenology is to identify common experiences for a group of people, this research will focus only on adults diagnosed with mood disorder to ensure the homogeneity of the sample.
Procedures
Psychiatric patients that had received psychotherapeutic interventions from PMHNs will be asked to describe their (1) satisfaction with the healthcare service provided, (2) the perceived quality of communication with the care provider, (3) emotional rapport quality, (4) perceived positive outcomes of the treatment, and (5) the most significant barriers experienced during the treatment. Their responses will be recorded, but if the participants refuse to be recorded, they will be asked to provide the answers in writing. Before each interview, the researcher will perform bracketing, which requires identifying personal presuppositions and prejudgment that might interfere with formulating the meaning to the participants’ statements.
Data Analysis
Collaizi’s method of phenomenology will be used to analyze the data. The method consists of six steps, which include (1) reading the participant’s answers in order, (2) identifying and extracting significant statements related to the experience, (3) formulating meanings for every statement, (4) organizing the meanings into themes, (5) making a detailed description of the common themes identified, (6) and making the final analysis validation by sharing the description with the participants. If any new relevant data is introduced during the sixth step, the researcher will include that data into the analysis and description.
Practical Implications
Most evidence-based practices are determined by quantitative studies that evaluate the outcomes, adherence rates, and drop-out rates of certain interventions, but qualitative studies help the healthcare practitioners understand the experiences of their patients and the meanings of those experiences (Munhall, 2012). It is expected that this study will increase the understanding of the psychiatric patients’ needs and provide general directions for PMHNs toward improving care delivery to their patients (e.g. improving communication skills if necessary or recognizing and addressing barriers experienced by the patients during treatment).
Ethical Considerations
It is important to consider that encouraging participants to reflect on sensitive experiences can be emotionally stressful to individuals. Therefore, participants who were diagnosed with severe mood disorders and participants with comorbid substance abuse disorder will be excluded from the study. The participants who satisfy the inclusion criteria must be informed about the potential adverse events associated with reflecting on sensitive topics.
It is also important to provide full disclosure to the patients regarding the confidentiality practices and data protection. The participants’ personal information will not be disclosed in the research reports, and their data will be available only to personnel with authorized access. The methods in place for protecting their data will also be discussed. Once the participants have been briefed on privacy practices and the potential harms associated with the procedure used, they will be required to provide informed consent to participate in the research. However, they will have the right to withdraw at any time during the research.
References
Arving, C., & Holmström, I. (2011). Creating a new profession in cancer nursing? Experiences of working as a psychosocial nurse in cancer care. Journal of Clinical Nursing, 20(19‐20), 2939-2947.
Balls, P. (2008). Phenomenology in nursing research: Methodology, interviewing and transcribing. Nursing Times, 105(32-33), 30-33.
Hawamdeh, S., & Fakhry, R. (2013). Therapeutic relationships from the psychiatric nurses’ perspectives: An interpretative phenomenological study. Perspectives in Psychiatric Care. doi:10.1111/ppc.12039
Marks, I. M., Hallam, R. S., Philpott, R., & Connolly, J. C. (1975). Nurse therapists in behavioural psychotherapy. British Medical Journal, 3(5976), 144-148.
Munhall, P. (Ed.). (2012). Nursing research (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Poggenpoel, M., Myburgh, C. P. H., & Morare, M. N. (2011). Registered nurses’ experiences of interaction with patients with mental health challenges in medical wards in Johannesburg. Journal of Nursing Management, 19(7), 950-958.
Schroeder, R. (2013). The seriously mentally ill older adult: Perceptions of the patient–provider relationship. Perspectives in Psychiatric Care, 49(1), 30-40.
Thibeault, C. A., Trudeau, K., d’Entremont, M., & Brown, T. (2010). Understanding the milieu experiences of patients on an acute inpatient psychiatric unit. Archives of Psychiatric Nursing, 24(4), 216-226.
