Nurses' Perceptions of Patients With Co-Occurring Psychiatric and Substance Use Disorders in Psychiatric Settings: A Grounded Theory Study

AimTo explore psychiatric and mental health nurses' perceptions of patients with co-occurring psychiatric and substance use disorders in psychiatric settings.DesignAn exploratory qualitative study design based on grounded theory, employing Straussian analytic procedures.MethodSemi-structured interviews were conducted with 11 psychiatric and mental health nurses. Participants were recruited at a public psychiatric hospital located in the Paris metropolitan area of France. Face-to-face interviews took place between February 2024 and May 2024. Field notes and interview data were continuously analysed during open, axial and selective coding phases.ResultsThe core category identified was 'waiting for a patient's will to change to emerge' when caring for patients with co-occurring substance use disorders. This active waiting period involved a balancing strategy between two discrete care objectives: stabilising the patient's clinical status and keeping the nurse-patient relationship intact. Identifying a patient's will to change provided an opportunity to reconcile these two aspects of psychiatric nursing through the addition of a collaborative component to the relationship.ConclusionThe substantive theory generated by our findings contributes to understanding the interactional and relational processes that occur between nurses and patients presenting with co-occurring substance use disorders in the context of psychiatric care.Implications for the Profession and/or Patient CareImplications of our study include the need for further emphasis on collaborative approaches that can be applied even in early or pre-contemplative stages of recovery. Organisational policies should systematically include training in the field of addiction care, given the high prevalence of co-occurring substance use disorders in psychiatric settings.ImpactOur findings can assist nurses in critically examining the challenges they experience when engaging with patients with co-occurring substance use disorders.Reporting MethodThis research adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist.Patient or Public ContributionNo patient or public contribution.