Understanding Helpful Nursing Care From the Perspective of Mental Health Inpatients With a Dual Diagnosis: A Qualitative Descriptive Study

J Am Psychiatr Nurses Assoc. 2020 May/Jun;26(3):250-261. doi: 10.1177/1078390319878773. Epub 2019 Oct 5.

Abstract

BACKGROUND: An estimated 30% to 50% of people with a mental illness also have a substance use problem. Referred to as having a dual diagnosis, these patients experience high levels of unmet needs, poor health outcomes, and require specialized care during psychiatric hospitalization. Research on nursing inpatients with a dual diagnosis is limited and patient perceptions of helpful care during hospitalization are unknown. AIMS: What nursing interventions, attitudes, actions, and/or behaviors are perceived as helpful by patients with a dual diagnosis during psychiatric hospitalization? METHODS: A qualitative-descriptive design was used. Twelve adult inpatients with a dual diagnosis were recruited using purposive sampling. Individual, semistructured interviews were conducted, and interview data were analyzed using content analysis. RESULTS: Helpful nursing occurred across three themes: (1) promoting health in everyday living, (2) managing substance use in tandem with mental illness, and (3) building therapeutic relationships. CONCLUSIONS: Specific examples of helpful interventions and their reported outcomes reinforce the critical role that nurses play in the health and recovery of inpatients with a dual diagnosis. The importance of collaborative, strengths-based approaches is highlighted, and expanding the nurse's role to include evidence-based responses to substance use is recommended.

Keywords: acute hospital; dual diagnosis; nursing role; patient experience; substance abuse.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diagnosis, Dual (Psychiatry)*
  • Female
  • Humans
  • Inpatients* / psychology
  • Inpatients* / statistics & numerical data
  • Interviews as Topic
  • Male
  • Mental Disorders / therapy*
  • Middle Aged
  • Nurse's Role / psychology*
  • Nursing Staff, Hospital / psychology
  • Psychiatric Nursing
  • Qualitative Research
  • Substance-Related Disorders / therapy*