METHODS
A qualitative research methodology was selected to map the experiences
of the nurses in our study (Holloway & Wheeler, 2002). Semistructured
interviews were first conducted with the individual nurses.
Focus group meetings were then held to deepen our understanding of
the interview results. According to Dutch legislation, formal approval
of the ethics of the study was not needed from the Netherlands Central
Committee on Research Involving Human Subjects (www.ccmo.nl).
However, the Scientific Research Committees from the mental health
organizations participating in the current study did provide approval.
All of the participants signed an informed consent form prior to the
start of the study.
Data Collection
Recruitment of Participants
Nurses working on six wards from four mental health organizations
in the Netherlandswere asked to participate in the study. The managers
of the nursing teams working on these acute mental healthwards were
informed about the study and then asked to approach the nurses in their
teams to inform them about the study and ask them if they would be
willing to participate.
To participate in the study, the nurses had to be involved in the daily
nursing care for patients and play an active role in the formulation of
nursing care plans. Five nurses per ward from two wards agreed to
participate, also six nurses from another ward—all these wards are
part of different organizations. From three wards, part of another organization
but spread within a single geographic region, two nurses per
ward participated.
A total of 22 nurses thus agreed to participate in the present study.
Semi-structured Interviews
The semi-structured individual interviews were conducted by the
first author (TD) between December 2011 andMay 2013. A topic list derived
froma list used in a prior study of what nurses dowhen caring for
outpatients with a bipolar disorder (Goossens, Beentjes, de Leeuw,
Knoppert-van der Klein, & van Achterberg, 2008) was used to guide
the interviews (see Table 1).
Information on all personal data being kept anonymous was provided
prior to the start of the study and again prior to the start of
each interview.
With the aid of the topic list each nursewas asked to describe their experiences
with patient problems, desired patient outcomes, and nursing