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Introduction: Schizophrenia is a life altering illness affecting one percent of the population world wide. Engaging the patient with schizophrenia in treatment, both psychosocial and biological, is problematic despite the use of a myriad of treatment interventions demonstrating mixed results. There is a consensus by researchers that there is a need for a strong positive individual relationship between providers and patients. The caseloads of nurses in community mental health centers include patients with schizophrenia. Nurses have accepted the position of health care promotion and illness prevention for this group of patients. Nurses have a need to understand which interventions to use to promote treatment compliance for patients with schizophrenia in different manifestations of the illness.
Methods: The present research study using grounded theory provides a model of the nursing process identifying those aspects of the nurse/patient relationship which influences treatment compliance. Identified are the processes nurses in community mental health centers use to make decisions regarding which interventions to use with different manifestations of schizophrenia and how nurses make decisions regarding follow-up visits. Five expert nurses and fifteen patients participated in the study. Patients from three different levels of compliance were interviewed by each of the nurses. Data collection included participant observation of the nurse/patient interaction, field notes, memos, demographic questionnaires, interviews with the nurses post observation, and secondary literature review. The data was analyzed systematically as it was collected by constant comparative analysis, where newly acquired data and previously collected data were continuously compared with one another.
Results: The grounded theory research investigation identified a substantive theory which was supported by the data. The basic social process of “getting it” together, the core category of knowing, and the supporting categories of socializing, normalizing, and celebrating will be introduced and discussed with the supporting field data.
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