A model to support non-psychiatric trained nurses rendering care to mental health care users in acute psychiatric wards in Limpopo Province

Abstract

Background: Mental health care users are admitted to an acute psychiatric ward to receive nursing care, treatment, and rehabilitation services (Mental Health Care Ac 17 of 2002). Nurses in an acute psychiatric ward render speciality care to mental health care users according to their scope of practice. Caring for mental health care uses and working in an acute psychiatric ward led to many challenges among non-psychiatric trained nurses. They expressed feeling challenged in caring for mental health care users and distancing themselves from mental health care users. Aim: This study aimed to develop and validate a model to support non-psychiatric trained nurses rendering care to mental health care users in acute psychiatric wards in Limpopo province, South Africa. Method: Qualitative, explorative, descriptive, and contextual research designs were used to develop the model. Roy's Adaptation Model guided the study. The study was conducted in three phases. Phase one was situational analysis, which included study settings, sample, trustworthiness, and ethical consideration. This study was conducted in four acute psychiatric wards of the four selected public hospitals in Limpopo Province, South Africa. Three districts were selected namely: Capricorn, Waterberg, and Mopani Districts. The pre-test was done on three non-psychiatric trained nurses who were not part of the study. A convenience sampling technique was used to select the 20 male and female non-psychiatric trained nurses, six Enrolled nurses , and 14 Enrolled Nursing Assistance who participated in the study. Unstructured interviews were used to collect data until saturation occurred, all interviews were audio recorded. Participants were assured of confidentiality and anonymity throughout the study. Data were analyed using Tesch's eight steps. The concept support emerged from the findings. Phase two was concept analysis of the concept support using Walker and Avant guidelines. Phase three entailed model development and validation, led by Dickoff, James, and Wiedenbach's theory employing six practice theory elements: the context, agent, recipient, dynamic, process, and outcome. In addition, Chinn and Kramer guided validation of the model. Results: The following themes emerged: experiencing different emotional reactions, unsafe working environment, inadequate resources, lack of staff wellness services, knowledge and competencies deficit in mental health nursing, and support needs for non-psychiatric trained nurses in acute psychiatric wards. Conclusion: Inadequate support of non-psychiatric trained nurses leads to compromised quality patient care to mental health care users placing the community in danger as mental health care users will not be rehabilitated, which may lead to litigations by the community members. The model as a reference framework could comprehensively assist non-psychiatric trained nurses in rendering care to mental health care users