Experiences of ward atmosphere in inpatients with intellectual disability and mental illness: clinical implications for mental health nursing

Abstract

Background: Patients with intellectual disability in psychiatric services are rarely asked about their experiences when admitted to inpatient units. Aim: To enhance the understanding of ward atmosphere for inpatients with co-occurring intellectual disabilities (ID) and mental illness by exploring patients’ experiences from a specialised mental health inpatient unit. Methods: A selected sample of 10 adults with comorbid mental illness and ID were recruited for a qualitative interview study based on Gunderson’s conceptualisation of therapeutic components in mental health wards. The patients were interviewed by two experienced clinicians and interviews were analysed using directed content analysis. Results: Patients’ experience of their relationships with ward staff seemed central to their experiences of several aspects of mental health nursing. Feeling safe, contained, and validated, were further important aspects. However, the patients seemed to have little influence on treatment choices and did not report participating in shared decision-making. Conclusions: The patients’ answers in this study are in line with previous research on ward atmosphere for patients in the general population. However, more research is necessary to inform future mental health nursing for patients with ID, both in inpatient and ambulatory services.

A call for trauma‐informed dental care for individuals with intellectual disabilities

“…20 There have been suggestions from other health care services that a personal and safe therapeutic relationship may be particularly important for people with intellectual disabilities. 89,90 Because people with intellectual disabilities may understand and analyze stressful situations in a different manner, 53 other aspects of the dental care situation may be triggering for these individuals than for other trauma survivors. Furthermore, trauma-related reactions may manifest as motor restlessness, aggressive or self-harming behaviors, apparent noncompliance, changed responsivity, or changes in arousal that may be challenging to observe.…”

“…Attention to the patient's mental state is still recommended, as trauma‐related reactions may result in a freeze response involving immobility, rendering the patient unable to communicate with signs or gestures 20 . There have been suggestions from other health care services that a personal and safe therapeutic relationship may be particularly important for people with intellectual disabilities 89,90 …”

Implementasi Inovasi Keperawatan “Therapeutic Atmosphere” di Ruang Rawat Inap

“…Mencipatakan suasana ruang rawat inap yang terapeutik merupakan suatu usaha yang harus dilakukan oleh tenaga pelayanan kesehatan (Sommerstad et al, 2021). Therapeutic atmosphere dirancang dalam suatu lingkup rawat inap dengan melibatkan lingkungan pasien.…”

‘I felt alive’: A qualitative study of inpatients' perspectives on good mental health nursing in South Korea

“…Patients expect to receive nursing care based on respect, individualization, and empowerment from MHNs (Moreno‐Poyato et al, 2016). However, in reality, they have negative care experiences such as non‐therapeutic relationships, lack of respect, insufficient treatment information, limited shared decision making, and inadequate formal and informal conversations (Cutcliffe et al, 2015; Sommerstad et al, 2021).…”