Brief admission (BA) for patients with emotional instability and self-harm: nurses’ perspectives - person-centred care in clinical practice

Abstract

Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient’s needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses’ experiences working with BA related to patients with emotional instability and self-harm.Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis.Results: Four main categories emerged regarding nurses’ experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient’s health and empowers the patient. The nurse’s role shifted from “handling problems” to establishing caring relationships with a focus on the person’s health and possibilities for recovering instead of psychiatric symptoms.Conclusions: Previous studies on patients’ perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care.

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

“…The participants in the current study likewise described the experience of being listened to, taken seriously, and feeling incharge of their health as strengthening their confidence. From healthcare professionals’ perspective, increasing patients’ participation in their care management is an empowering component of BA (Eckerstrom et al, 2019). Additionally, BA patients expressed less hopelessness, powerlessness, and resignation compared to patients receiving ordinary inpatient care (Rise et al, 2014).…”

“…It consists of four constructs: prerequisites, the care environment, person‐centred processes, and expected outcome. The content and relationship of these components align with the core aspects of BA, which promotes increased autonomy and participation through a customized care environment (Eckerstrom et al, 2019). There are currently several ongoing research projects evaluating BA, and the systematic outcomes from these studies will be critical in further understanding the clinical utility and effectiveness of this method.…”

“…Both wards had one room allocated and customized specifically for BA. This article reports the project’s first study focusing on patients’ perspective and is part of a larger ongoing research project about BA (Eckerstrom et al , 2019).…”

“…A previous qualitative study on psychiatric nurses’ experience of working with BA described the intervention as empowering patients and providing meaningful and constructive psychiatric inpatient care (Eckerstrom et al, 2019). Helleman et al (2014a) reviewed the research literature to identify the key components of BA and the following five elements crystallized: (1) a discussion of the goals in advance, (2) the organization of BA (i.e.…”

Mental health nurses' experiences of implementing a model to facilitate self‐empowerment in women living with borderline personality disorder in South Africa

“…Previous studies have shown that brief admissions have empowered clients diagnosed with BPD. The clients diagnosed with BPD displayed signs of being empowered by taking more responsibility and being a “co‐worker” in their mental health (Eckerström et al, 2019). Mental health nurses who participated in the study shared the perspective that women who live with BPD experienced increased levels of self‐empowerment during their eight‐week admission.…”