Effective Home Visit Nursing for Clients with Schizophrenia: Its Purposes and Skills

Abstract

This study is aimed at exploring the nursing purposes and skills in effective home visit nursing for clients with schizophrenia. Subjects were seven home visit nurses and their nine clients, the latter having no experience of hospitalization for two years or more while they were assisted by the nurse. The interviews with the nurses and the field notes on the observation of their practice were analyzed qualitatively.In effective home visit nursing, the nursing purpose changed from that before establishing the stage of having a common understanding between the client and the nurse regarding how the client wanted to live to new nursing purpose afterwards. Before establishing this 'common understanding' stage, the purpose of nursing was 'letting out the client's oppressed will.' The nurses used the skills such as 'observing the client's situation using all of the nurse's perceptive powers,' 'understanding the client's experiences living with mental disorder,' 'understanding the client's individuality,' and 'intentionally utilizing one's non-professional self.' After establishing the stage of having the common understanding between the client and the nurse, the purpose changed to 'cultivating the client's living ability.' Although most nursing skills were changed based on the change in the purpose, the use of some skills were seen both before and after establishing the stage of having the common understanding between the client and the nurse. Following the 'common understanding' stage, the nurses used the skills such as 'knowing the client's ability of daily living,' and 'using both professional and non-professional self.'