Experiences of Professional Nurses in Caring for Psychiatric Patients With Dual Diagnosis

Purpose:

Dual diagnosis is a serious concern in the whole world and very little is known about the care of psychiatric patients with dual diagnosis (Phillips, McKeown & Sandford, 2010). Dual diagnosis implies that psychiatric disorders occur at the same time, or one follows the other and eventually, it is difficult to tell which occurred first (Fortinash & Worret, 2012). The purpose of this study was to explore and describe the experiences of professional nurses in caring for psychiatric patients with dual diagnosis in order to make recommendations that could assist them in improving care for psychiatric patients with dual diagnosis in a psychiatric hospital in the North West Province of South Africa.

Methods:

The target population of this study consisted of professional nurses caring for psychiatric patients with dual diagnosis in a psychiatric hospital in the North West Province of South Africa. A non-probability sampling approach was used and participants were selected purposively based on the selection criteria. The sample size was determined by data saturation. A qualitative, exploratory, descriptive and contextual design was used in this study. Unstructured interviews were conducted with professional nurses caring for psychiatric patients with dual diagnosis. A tape recorder was used to record the interviews and these were transcribed verbatim. Data were analysed qualitatively using Tesch’s (in Creswell, 2009) method of content analysis. Trustworthiness was ensured through credibility, dependability, transferability and conformability.

Results:

Emerging themes were examined in line with the objectives of the study and confirmed through literature control. After the data were analysed, three major categories were identified from the twelve unstructured individual interviews with professional nurses. The findings of this study revealed that professional nurses had negative experiences namely, feeling unsafe, difficulty in caring for these patients, lacking information and fear associated with caring. Positive experiences included that caring for patients with dual diagnosis in not complicated, that substances are not accessible in the hospital situation, that they can be controlled in hospital, that there are programmes designed to care for them and that there is treatment for psychiatric patients with dual diagnosis; they also had suggestions to make regarding caring for patients with dual diagnosis including that in-services training and workshops should be conducted, that there should be halfway houses for them, that management should support them, that there must be collaboration within the Multidisciplinary team members, provision of safe environment as well as provision of more professional nurses.  The recommendations were made for nursing practice, nursing education and nursing research.

Conclusion:

It was concluded that professional nurses caring for psychiatric patients with dual diagnosis experience both negative and positive experiences. However, they also suggested strategies that could be implemented to improve the care of these patients in order to mitigate their negative experiences in caring for Psychiatric patients with dual diagnosis.