Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.

The current philosophical paradigm in psychiatry is based in logical positivism, as outcomes are viewed as objective and scientifically verifiable. This approach, although making important contributions to the field, fails to acknowledge outcomes from the perspective of the client. A growing movement within the mental health field is promoting the use of phenomenology and the lived experience, which provides new opportunities for defining outcomes from the client’s perspective. The purpose of this article is to briefly review the main tenets of both philosophical perspectives and to demonstrate how these perspectives influence the conceptualization of outcomes in psychiatric-mental health nursing practice and research. Finally, a proposal is made for clinicians and researchers to adopt an integrative model, a blending of the two viewpoints, to capture the most complete experience of the client and to define the most appropriate outcomes.