Psychiatric nurse's perceptions of their interactions with people who hear voices: A qualitative systematic review and thematic analysis

Abstract

What is known on the subject?• There is no qualitative systematic review of nurses' perceptions of their interactions with people hearing voices. There are some studies exploring the interventions provided by community psychiatric nurses to people hearing voices; these give a sense of what interactions may contain. What the paper adds to the existing knowledge?• Nurses across both community and inpatient mental healthcare settings feel uncertain about how to interact with people hearing voices, sometimes feeling like they can do little to help. Their interactions are affected by the workplace culture, education and training and concern for their own safety. Nurses rely on a therapeutic relationship for all interactions. What are the implications for practice?• This is an under investigated area of mental healthcare. None the less this qualitative systematic review highlights that nurses are unclear about how to interact with service users hearing voices with the resultant outcome that service users in great distress may only be receiving minimal benefit from their interactions with the nurses caring for them.

Shortcomings of services for persons with severe and persistent mental health challenges: a qualitative study of service users and family carers

“…Some argue that the main obstacle to achieving person-centred care relates to concerns of healthcare professionals about risk and decision making capacity of service users ( 58 ) while others have reported that staff (mental health nurses) often feel helpless when faced with individuals presenting with severe mental illness and their interactions with them were influenced by the workplace culture, education and training as well as concern for their own safety ( 59 ).…”

Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study

“…The literature shows several studies focussing on nurses’ or nursing students’ perceptions of the therapeutic relationship with patients [ 5 , 21 ]. However, no studies were found that specifically considered the mentally ill patients’ perspective on this relationship, its importance, and what they expect from nurses concerning their behaviour and attitudes.…”

All I missed in the therapeutic relationship: The lived experience narrative of a mental health nurse receiving mental healthcare

“…The therapeutic relationship is not always functional in clinical practice, and there is some discrepancy between the ideals of mental health nursing and actual practice in the form of reduced availability and accessibility. The therapeutic relationship may be negatively influenced by various factors, such as lack of time, lack of job motivation, exhaustion and rejection towards the person cared for (Hem & Heggen, 2004, Moreno‐Poyato et al, 2016, McCluskey et al, 2022). Rejection is reflected in clinical practice as distance, which can be helpful in maintaining the service user's dignity, but it could also appear as a result of personal dislike (Hem & Heggen, 2004).…”

“…The therapeutic relationship has been defined as the cornerstone of mental health practice and pivotal to recovery‐oriented mental healthcare (McCluskey et al, 2022). The views of the therapeutic relationship seem to be similar both for nurses and mental health service users, framed as one‐party wishing to help and the other to be helped, and resting on trust and respect (Moreno‐Poyato et al, 2016).…”

“…The views of the therapeutic relationship seem to be similar both for nurses and mental health service users, framed as one‐party wishing to help and the other to be helped, and resting on trust and respect (Moreno‐Poyato et al, 2016). Service users believe that the most desirable qualities of mental health nurses are those essential for the development of a therapeutic relationship: active listening, showing empathy and understanding the service user's unique experience (McCluskey et al, 2022).…”