Understanding home psychiatric nursing: a phenomenological study on nurses’ challenges, emotional resilience, and professional growth in Jeddah, Saudi Arabia
Résumé
Background: Home-based psychiatric nursing involves distinct challenges compared to inpatient care, including unpredictable care environments, complex family dynamics, and heightened emotional demands. Understanding nurses' lived experiences is essential for strengthening workforce readiness, resilience, and professional development, particularly in Saudi Arabia where community mental health services are expanding. Aim: This study explored the lived experiences of home psychiatric nurses in Jeddah, Saudi Arabia, focusing on perceived challenges, coping strategies, emotional resilience, and professional identity development. Methods: A qualitative interpretive phenomenological design, guided by Van Manen's phenomenology, was employed to examine nurses' lived experiences. Resilience Theory informed the exploration of coping mechanisms and emotional adaptation, while Meleis' Transition Theory provided a conceptual lens for understanding nurses' professional role transitions from hospital-based to home-based psychiatric care. Semi-structured interviews were conducted with 20 home psychiatric nurses, and data were thematically analyzed to identify patterns of meaning across participants' narratives. Results: Five interrelated themes emerged: (1) Entering Home Psychiatric Care: Preparedness, Training Gaps, and Developing Autonomy; (2) Navigating the Complexity of Home Environments and Workload Demands; (3) Emotional Labor, Compassion Fatigue, and Coping Strategies; (4) Ethical Dilemmas, Safety Risks, and Limited Institutional Support; and (5) Professional Growth, Identity Transformation, and Meaningful Engagement. Conclusion: Home psychiatric nursing requires competencies beyond traditional hospital-based training, particularly in resilience, ethical decision-making, and adaptive professional practice. Organizational support, targeted training, and clear safety frameworks are critical for sustaining nurses' well-being and optimizing patient care. These findings offer theoretically informed insights to guide policy, education, and service development in community mental health care in Saudi Arabia.
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