Strategies in caring for women with postpartum psychosis—an interview study with psychiatric nurses

Inger Engqvist, Agneta Nilsson, Kerstin Nilsson, Björn Sjöström
Journal of Clinical Nursing 2007, 16 (7): 1333-42

AIM AND OBJECTIVE: The aim of this study was to explore strategies in caring for women with postpartum psychosis used by nurses.

BACKGROUND: The most serious type of psychiatric illness in connection with childbirth is postpartum psychosis. Nearly two in 1000 newly delivered women are stricken by postpartum psychosis. Most of these patients need psychiatric care to recover. While earlier studies point to the need for psychiatric care, knowledge of specific nursing strategies in caring for postpartum psychosis patients remains limited.

METHODS: Interviews with 10 experienced psychiatric nurses were carried out, transcribed verbatim and an inductive content analysis was made.

RESULT: The main strategies for care found in this study were: (i) To create a patient-nurse relationship and (ii) To apply nursing therapeutic interventions. Presence, continuity and nurse-patient partnership contributed to create a relationship and incorporate the rest of the care team. To satisfy the patients' basic needs and feeling of security was the foundation of the nursing therapeutic interventions. Confirmation and giving hope were also used as nursing therapeutics as well as information to the patient and her relatives about her illness.

CONCLUSION: The conclusion of the study is that strategies used by nurses are a combination of general and psychiatric nursing approaches but the specificity in caring knowledge for caring patients with postpartum psychosis requires further development.

RELEVANCE TO CLINICAL PRACTICE: The result of the study indicates that it is important to organize patient care for postpartum psychosis with continuity and consistency and to support the nurse to create a relationship and therapeutic intervention with the patient. The present study shows the importance of further developing specific nursing theories that can be applied when caring for patients with postpartum psychosis. It also shows the need for further pedagogical education for mental health nurses.

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