Process of Building Patient-Nurse Relationships In Child And Adolescent Psychiatric Inpatient Care: A Grounded Theory Approach In Japan

Objective: The objective of the present study is to describe the process of building closer patient-nurse relationships in child and adolescent psychiatric inpatient care. Nurses play important roles in psychiatric inpatient care for children and adolescents, and their care can affect every facet of their daily life. The efficacy of treatment depends on the nurses’ ability to build intimate patientnurse relationships.

Methods: A qualitative methodology, based on the tenets of grounded theory approach, was taken. Semi-structured in-depth interviews were conducted with 18 expert nurses and analyzed using a constant comparative method.

Results: ‘Developing emotional attachment’ was identified as the core category, substantiated by four interrelated stages: ‘Becoming a target of attachment’; ‘Forming an attachment’; ‘Expanding the target of attachment’; and ‘Preparing to be a target of attachment’. We found that in developing emotional attachments with inpatient children or adolescents, expert nurses achieved a balance between appropriate psychological distance from - and their own increased attachment to - those inpatients.

Conclusions: The “expert” nurses become a target of attachment for their patients and then successfully extend that to other nurses during professional nursing intervention.