Exploring Nurses' Experiences in Caring for Medical-Psychiatric Comorbid Patients: A Qualitative Interview Study

Area of Science:

• Nursing
• Psychiatry
• Healthcare Management

Background:

• One-third of general hospital patients have mental disorders, increasing costs and worsening outcomes.
• Caring for patients with medical-psychiatric comorbidities presents unique challenges for nurses, including managing difficult behaviors.
• Existing support structures and training may be inadequate for addressing these complex patient needs.

Purpose of the Study:

• To explore registered nurses' experiences caring for patients with medical-psychiatric comorbidities in general hospital settings.
• To identify the key challenges and coping strategies employed by nurses in these situations.
• To inform the development of improved support systems and educational interventions.

Main Methods:

• Qualitative study utilizing semi-structured interviews.
• Participants included 16 registered nurses from eight wards in a Dutch university medical centre.
• Data analyzed using Braun and Clarke's inductive thematic analysis.

Main Results:

• Nurses' experiences were categorized into three themes: managing emotions, adapting to contextual factors, and building competence.
• Challenges included emotional regulation (frustration to compassion), time pressures, competing demands, and unsuitable environments.
• Competence building involved experiential learning, highlighting needs for education and multidisciplinary collaboration.

Conclusions:

• Nurses' difficulties stem from limited training, organizational structures, and systemic barriers, rather than solely patient behavior.
• Effective care requires organizational, educational, and interprofessional support beyond individual coping mechanisms.
• Simulation-based training, structured reflection, and interprofessional collaboration can enhance nurse competence and confidence, improving patient care and well-being.