Abstract
Objectives: This study aimed to identify the process of nursing practice among expert nurses in relation to long-term patients with schizophrenia, from the time when the nurses started to consider patient discharge and provide discharge support to the completion of such support.
Methods: We conducted semi-structured interviews with 13 nurses who consented to participate in the study. The data obtained were analyzed employing a qualitative and inductive approach.
Results: The following 7 categories were extracted: 〈the possibility of discharge presented and facilitated by an ongoing understanding of the patient〉, [bringing out the patient's hope for discharge that lies deep in his/her mind], [sharing intentions with the primary physician who is reluctant to provide discharge support], [understanding the feelings and backgrounds of the patient's family members who disagree with discharge], [developing networks by adopting a primary nurse-centered approach], [fulfilling the roles of a primary nurse to provide peace of mind], and [engaging with the patient on a one-on-one level to foster his/her confidence]. 〈The possibility of discharge presented and facilitated by an ongoing understanding of the patient〉 was observed to be a central phenomenon affecting all other categories, and, thus, was identified as the core category.
Conclusion: The process of nursing practice to provide discharge support for long-term patients with schizophrenia should include: flexible clinical judgment to enhance the probability of discharge by performing ongoing assessment of patients; and, the implementation of nursing interventions to help patients restore their hope for discharge that is diminishing, and respond immediately to any slight changes in them.
