Implications for Nursing Practice and Research
Using the AHIG yields many benefits, including allowing voice hearers to share their experiences of AH in a safe, structured manner. The AHIG provides structure for PMH nurses to invite patients to answer detailed questions during an individual interview about the onset of their voices and the voice hearing experience. These questions include asking about AH triggers and strategies patients use to help manage their AH, including commands to harm self and others.
Using the AHIG provides PMH nurses with the opportunity to convey empathy and practice good listening skills, which help build trust between voice hearers and mental health professionals. The AHIG provides shared terminology for experiences that may have been difficult for the voice hearer to describe to others. This terminology can then be shared with other mental health professionals working with the voice hearer toward recovery. For example, information collected with the AHIG can be used to develop an individualized care plan for the voice hearer. This care plan could include that the voice hearer prefers to have his voices called “thoughts” or that he hears commands to harm self but has never acted on them.
Students in psychiatric nursing often have a difficult time trying to talk to individuals with schizophrenia. The structure of the AHIG allows students and patients to feel more comfortable talking to one another. Students are often fascinated with what they learn during the interview and are pleased to be able to connect with patients; in addition, patients feel heard, and soon, the interaction progresses easily within the structure.
All tools require ongoing evaluation. The authors continuously seek feedback from clinicians who have incorporated the AHIG into their work with voice hearers in inpatient and outpatient settings. Any changes for brevity, flow, and content can then be re-evaluated. Clinicians often make alterations that better fit their situations. Therefore, the authors welcome others to use the AHIG and to submit feedback by completing the Feedback Form () and sending it to Dr. Robin K. Buccheri at buccherir@usfca.edu.
Future research is needed for establishing the usefulness of the AHIG for mental health clinicians from all disciplines in inpatient and community care settings, as well as for informal caregivers (e.g., support groups) and family members. In addition, a continuity of care evaluation is needed for the utility of the individualized care plan developed from the AHIG information.
Conclusion
PMH nurses must learn more about each voice hearer’s past and current experiences so they can provide individualized nursing care. The AHIG provides a structured 30- to 45-minute interview that can be used to assess voice hearers’ past and current symptoms and develop a therapeutic relationship. The AHIG contributes a theory-based, clinically tested, structured interview guide to the PMH nurse’s repertoire of assessment and communication tools. The tool has benefits for staff, nursing students, and voice hearers. By using the valuable communication skills of listening and conveying empathy, PMH nurses can establish a trusting and comfortable relationship that enables patients to be open and honest about hearing voices.