Renal nurses' experiences of patients with severe mental health conditions receiving acute haemodialysis: A qualitative study

Abstract

Background Patients receiving acute haemodialysis treatment and living with severe mental illness may display behaviours that are perceived as challenging and stressful for renal nurses to manage in the acute haemodialysis unit. Renal nurses are historically trained on the technical aspects of acute haemodialysis and can provide a level of psychological support to patients. However, they have not been trained to manage patients with severe mental illness. Objective To explore renal nurses' experiences of nursing patients with severe mental illness receiving acute haemodialysis, and to identify factors that facilitate or hinder the nursing care of these patients. Design A descriptive qualitative study. Method Purposive sampling was employed, and semi‐structured interviews were conducted with 10 renal nurses working in an acute haemodialysis unit. Thematic analysis was utilised to analyse the data. Findings Thematic analysis identified four main themes which are perspectives of mental Illness, patient and staff safety concerns, facilitators of care and education and support needs. Conclusion Renal nurses experienced difficulty managing challenging behaviours manifested by patients with severe mental illness. Despite the various challenges, renal nurses adopted a person‐centred approach. Staff shortages and lack of training were significant hindrances to care delivery. Education on mental health conditions, support from senior staff and collaborative working can enable confidence and increase renal nurses' knowledge and experience in mental health care.

Improving kidney care for people with severe mental health difficulties: a thematic analysis of twenty-two healthcare providers’ perspectives

“…Renal healthcare participants lacked confidence in their understanding of mental health and their ability to care for people with SMHDs, consistent with previous research ( 33 ). Given the wide range of SMHDs and the complexity of kidney care for this cohort, findings indicate that renal healthcare providers require individualised input from mental healthcare professionals on a case-by-case basis.…”

“…Despite the higher risk for kidney disease in people with SMHDs and the observed poorer outcomes for this population, research investigating kidney care for people with SMHDs is limited. To our knowledge, the only published research in this field is a qualitative study exploring the experiences of renal nurses providing acute haemodialysis to people with SMHDs, which did not focus specifically on barriers or facilitators to care ( 33 ). Nurses in this study described working with people with SMHDs as “challenging,” and identified staff shortages and lack of staff education regarding mental health as barriers to care.…”

Chronic kidney disease and severe mental illness: a scoping review

“…One study explored the experiences of renal nurses providing care to people with SMI receiving haemodialysis [ 45 ]. The main barriers to providing effective care were staff shortages, and a lack of staff education on mental illness.…”

Educational Needs for Psychiatric Nursing Competencies among Non-Psychiatric Nurses

“…비정신과 간호사란 정신과 병동 간호사의 상대적인 개념으 로 일반병동과 특수병동에 근무하는 간호사를 칭하며 [8], 비정 신과 간호사들은 정신질환자를 까다롭고 예측할 수 없을 뿐 아 니라, 공격성이 잠재된 위험한 존재라는 부정적 태도를 가진 것으로 나타났다 [9,10]. 이로 인해 비정신과 간호사들은 환자 를 회피하거나 정신과적 이상행동을 방치하기도 하며 [8], 환자 에게 도움이 되는 간호를 제공하기를 원하더라도 정신간호에 대한 지식과 기술 부족을 호소하며 [10,11], 본인이 제공하는 정 신간호가 효과적인지 확신하지 못한다고 하였다 [7,12]. 또한, 바쁜 업무 수행과정에서 정신간호는 자신의 업무라고 생각하 지 않아 [13,14], 정신질환자가 호소하는 신체적, 정신적 문제를 늦게 발견하여 죄책감을 느끼거나 [8], 공격, 자살 시도 등 정신 과적 응급상황 발생 시 무력감을 느낀다고 하였다 [9].…”