Patients’ experiences of psychosis in an inpatient setting

Abstract

The aim of this report was to describe patients' experiences of psychosis in an inpatient setting. Mental illness, as a result of psychosis, has traditionally been defined from the viewpoint of clinical experts. Psychiatric nursing, as an interactive human activity, is more concerned with the development of the person than with the origins or causes of their present distress. Therefore, psychiatric nursing is based on eliciting personal experiences and assisting the person to reclaim her/his inner wisdom and power. The design of the study, in the report discussed below, was phenomenological. In 1998, nine patients were interviewed regarding their experiences of psychosis in an acute inpatient setting. The verbatim transcripts were analysed using Giorgi's phenomenological method. The participants experienced psychosis as an uncontrollable sense of self, which included feelings of change and a loss of control over one's self with emotional distress and physical pain. The participants described the vulnerability they had felt whilst having difficult and strange psychological feelings. The informants experienced both themselves and others sensitively, considered their family and friends important and meaningful, and found it difficult to manage their daily lives. Furthermore, the informants experienced the onset of illness as situational, the progress of illness as holistic and exhaustive, and the admission into treatment as difficult, but inevitable.

Researching clients' experiences: A review of qualitative studies

“…This method is also not without its detractors, with concerns that an investigation that explores the views of clients may 'open up old wounds' (Howe, 1996). However, a reported disagreement between clients' and therapists' perceptions regarding experiences of therapy and other aspects of mental health care suggests the importance of maintaining an interest specifically in client views (Elliott & James, 1989;Feifel & Eells, 1963;Haglund et al, 2003;Koivisto, Janhonen, & Vaisanen, 2003;Sainfort, Becker, & Diamond, 1996;Todd, Deane, & Bragdon, 2003;Watts & Priebe, 2002).…”

“…Qualitative research describing clients' general experiences of mental health services include recovery from psychosis (Chadwick, 1997;Forchuk, Jewell, Tweedell, & Steinnagel, 2003), the experiences of involuntary psychiatric care (Johansson & Lundman, 2002), forced medication (Haglund et al, 2003), being an inpatient (Koivisto et al, 2003) and being diagnosed or labelled mentally ill (Hayne, 2003).…”

“…a sense of powerlessness when being admitted involuntarily or when trying to talk to staff who 'just kept pushing the tablets' and 'wouldn't listen to you' (Chadwick, 1997). Other themes included experiences of loss of control, confidence, involvement, freedom and loss of self (Haglund et al, 2003;Johansson & Lundman, 2002;Koivisto et al, 2003). In relation to diagnosis, reports include the huge sense of insecurity and isolation experienced (Koivisto et al, 2003) while on involuntary admission and forced medication feelings of 'violation' and the 'psychological damage'.…”

Losses related to everyday occupations for adults affected by mental illness

“…Yet, the symptoms, treatments, or other factors associated with mental illness, such as stigma, may generate profound challenges or losses related to engaging in occupations. Many occupations, or the resources or abilities required to engage in them, may be lost for people with a mental illness, including: work and job opportunities (4)(5)(6)(7)(8)(9)(10), roles (4,11,12), routines (13), motivation, energy (5), sleep (14), concentration or memory (15). Furthermore, some losses may perpetuate further loss.…”

Magnet Forces: A Structure for a Transformation in Inpatient Psychiatric Nursing

“…In qualitative interviews, people who had experienced psychosis spoke about the attendant experience of vulnerability. Participants described how at the point of psychosis they needed to feel safe, a safety that came from a reliable environment with nurses aware of and monitoring their situation (Koivisto, Janhonen, & Vaisanen, 2003). These patients suggested at this point of vulnerability staff should help them in dealing with the distress of temporarily losing a sense of self and loss of control over themselves (Koivisto, Janhonen, & Vaisanen, 2004).…”