Child-rearing Support Provided by Public Health Nurses to People with Mental Illness: Qualitative Descriptive Study

Abstract

Background:The growing rates of deinstitutionalization in Japan have resulted in an increase in the number of children being raised by parents with mental illness. Given this situation, public health nurses working for local governments play an important role.Objective:The purpose of this qualitative descriptive study was to describe the child-rearing support provided by public health nurses to parents with mental illness.Methods:Seven nurses identified 28 cases of parents with mental illness. Descriptions of the goals and details of the appropriate nursing support were extracted from transcripts, coded, and categorized.Results:Parents with mental illness diagnosed with addiction and personality disorders were more difficult to support than those diagnosed with mood disorders or schizophrenia. Public health nurses supported parents with mental illness with the aim of achieving goals such as “building continuous consultative relationships,” “ensuring living conditions had a minimum level of safety and comfort,” “parents playing their roles,” “parents and children living together in the community,” and “fostering children’s growth.” While they provided support by “assessing their relationships with parents,” “building consultative relationships with parents,” “assessing parents’ illnesses/disorders and supporting,” “assessing child-rearing abilities and supporting,” and “cooperating with related agencies,” they tended to focus on the growth of the children rather than the recovery of parents.Conclusion:Consultative relationships were the beginning of support, as well as the most important and difficult skill. Public health nurses need to provide support for the recovery of parents with mental illness and learn about personality disorders and addiction.

A randomized controlled study of an e-learning program (YURAIKU-PRO) for public health nurses to support parents with severe and persistent mental illness and their family members

“…In addition, one spouse and two adult children of parents with SPMI who ran self-help groups participated in two meetings and provided comments. First, the author developed a draft video using the findings from previous interviews and a survey of parents with SPMI [ 47 ], their spouses [ 48 ], children [ 49 ], public health nurses [ 23 ], and child welfare workers [ 50 ]. Various opinions on most comments, including the structure and content of the video, were shared and reflected in the videos.…”

“…As tier two aimed to raise the professionals’ awareness of the parents’ and children’s needs, understanding mental disorders (Module1), the impact of disorders on parenting (Module 2), family needs, and family-focused practices (Module 4) were included in this program. As tier three, Modules 5 and 6 are for professionals in charge of maternal and child health or welfare; and were developed in this program based on interviews that were conducted [ 23 , 50 ]. Modules 5 and 6 include building therapeutic relationships and interagency collaboration.…”

“…Therefore, it is important for nurses to improve the knowledge and skills necessary to support parents with SPMI [ 26 ] and reduce stigma and negative attitudes toward parents [ 26 , 34 , 35 ]. Family-focused practices [ 18 , 19 , 26 , 28 , 29 ], building therapeutic relationships [ 21 , 23 , 26 ], and interagency collaboration [ 18 , 21 , 26 , 28 ] are important skills for supporting parental SPMI. Nurses should develop these skills and increase their self-efficacy to support parents with SPMI and their family members in the community.…”