Disconfirmed in one's otherness: A comparison between the nurse's view of the patient's past, present and future and the patient's own view of the past, present and future

Abstract

This study is part of a larger project, the aim of which is to elucidate ''mental health nurses'' attitudes towards their patients'. In this study, nurses' and patients' attitudes are described from the perspective of both parties using a qualitative approach. The informants were selected from a rehabilitation unit for young adults, below 40, suffering from psychosis at a psychiatric clinic that provides acute psychiatric care. The informant group consisted of three dyads: three patients with various diagnoses and three nurses with primary responsibility for the patients' daily care. The aim of this particular study was to extend our preliminary understanding of nurses' attitudes towards psychiatric patients in the context of psychiatric inpatient care, by elucidating the patient's ''inner'' picture of her/his past, present and future and the nurse's picture of the same patient's past, present and future. Data were collected and analysed using a phenomenological-hermeneutic approach and the narrative picturing technique. For each picture and group, 15 related sub-themes emerged, on the basis of which six themes were formulated. The findings show that the nurses overrate their own importance when it comes to the patient's well-being on the ward. All the nurses emphasize confirmation and safety as the basis of their nursing care, while in the patient's picture the nurses represent a replication of childhood demands, which probably means that nursing care risks becoming a continuation of the patient's childhood estrangement.

Patients treated for psychosis and their perceptions of care in compulsory treatment: basis for an action plan

“…In the acute stage, psychiatric nurses can make it easier for patients by facilitating meaningful daily occupation. This has been shown to be important even for patients detained for compulsory treatment, and it supports patients towards better managing their daily lives after they are discharged (Lilja & Hellzén 2007).…”

“…Many patients do not understand why they have been admitted under compulsion and feel humiliated at being controlled by others (Olofsson & Jacobsson 2001, Kjellin et al 2004, Kuosmanen et al 2007. Compulsory treatment can also violate patients' self-esteem and make them feel powerless and as if they are not respected, acknowledged as human beings (Kjellin et al 2004, Kuosmanen et al 2007, Svindseth et al 2007, Lilja & Hellzén 2008 or treated like adult individuals (Lilja & Hellzén 2007, 2008.…”

Former patients' experience of psychiatric care: A qualitative investigation

“…Previous study of nurses' attitudes indicates that the patients experienced the staff members mainly as ‘parenting’ them. Instead of reciprocity and interplay patients experienced their time on the psychiatric wards as reminiscent of the estrangement they had experienced in childhood and adolescence (Lilja & Hellzen 2007).…”

“…2006). When comparing nurses' views of patients' past, present and future with the patients' own pictures of their past, present, and future, it became clear that there were differences (Lilja & Hellzen 2007). These incongruence's suggest that nurses' views blur the patients' uniqueness and thus obstruct the nurses' abilities to see the meanings of the patients' actions.…”

Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry

“…This could also influence patients to experience insecurity and powerlessness. This is because nurses do not see the patient as dynamic individuals; rather, they are viewed as or she is but static, one-dimensional people (Lilja & Hellzén, 2007). According to Olausson et al (2019), a relationship can be a lifeline-saving the patient from loneliness and contributing to their wellbeing.…”