The current nursing care of patients diagnosed with dual diagnosis: a comprehensive literature review

Abstract

Background: Nursing care of patients diagnosed with dual diagnosis poses significant challenges such as limited resources, low levels of education, limited standardised treatment packages and guidelines. Understanding current approaches to providing nursing care for these group of patients is crucial, as it allows advancement in research towards improving patient outcomes and guidance for the nurses. Aim: This comprehensive literature review seeks to synthesise literature on the current nursing care of patients diagnosed with dual diagnosis. Method: The comprehensive literature review follows the guidelines by Onwuegbuzie and Frels. The search for records was conducted in four databases including CINAHL, MedLine PsycINFO, and ScienceDirect. Additional grey literature was searched with the help of Google Scholar. Keywords used were dual diagnosis, co-occurring disorders, comorbid, nursing care, nursing. A total of 7 articles met the eligibility criteria and were included in the review. Results: The evidence from the synthesis reveals a complex interplay between systemic processes, therapeutic relationships, and intervention outcomes, with both psychosocial and pharmacological modalities contributing to patient recovery. Five overarching themes were identified: structural deficiencies in care planning and documentation, therapeutic relationships as the basis of engagement, efficacy of psychosocial interventions such as psychoeducation and skill-building and individual counselling for behaviour change, role of pharmacological interventions within integrated care such as lurasidone for psychotic symptom and craving reduction and long-acting injectable aripiprazole for functional gains, barriers to sustained engagement such as impact of medication side effects and relapse and insufficient aftercare and trauma-informed practices. Conclusion: Nursing care of patients diagnosed with dual diagnosis is most effective when integrated, patient-centred, and combining psychosocial with pharmacological approaches. Therapeutic relationships, consumer engagement, and structured planning support recovery. However, documentation gaps, low participation, and poor aftercare remain barriers needing innovation, policy, and research. Clinical trial number: Not applicable.