The difficult inpatient: identification and response by staff

Area of Science:

• Psychiatry
• Nursing
• Mental Health Care

Background:

• Understanding the patient experience is crucial in psychiatric care.
• Identifying challenging patient behaviors is essential for effective treatment.
• Healthcare professionals' subjective experiences impact patient care.

Purpose of the Study:

• To explore the phenomenology of "difficult" psychiatric inpatients.
• To identify patient behaviors and characteristics perceived as difficult by healthcare staff.
• To examine the feelings and experiences of nurses and residents when caring for difficult patients.

Main Methods:

• Pilot study involving 25 nurses and 12 psychiatric residents.
• Qualitative data collection through interviews.
• Content analysis of described patient behaviors, characteristics, and staff feelings.

Main Results:

• Similar diagnostic categories of "difficult" patients were identified by both groups.
• Both nurses and residents experienced feelings of incompetence and lack of control.
• Nurses' responses were more personalized and affect-laden, while residents were more system-oriented and objective.

Conclusions:

• Healthcare professionals share common perceptions of difficult psychiatric inpatients.
• Differences in emotional expression and attribution exist between nurses and residents.
• Addressing these differing experiences may improve staff support and patient care strategies.