Unconditional acceptance in the nurse-patient therapeutic relationship as a whole: An exploratory qualitative study in the context of mental health services

Abstract

Background: In order to establish a therapeutic relationship of quality, patient acceptance is fundamental. However, from an empirical point of view, acceptance has been poorly studied in the context of mental health nursing. Aim: To explore the meaning and importance that people with mental health problems and mental health nurses assign to the concept of acceptance in the context of the nurse-patient therapeutic relationship. Design: A qualitative study with an exploratory approach. Methods: People with different mental health problems and nurses from different care settings working in mental health services participated in the study. Focus groups were used for data collection and the data analyzed were inductively using content analysis. This study complied with the COREQ research guidelines. Results: For the participants, acceptance as part of the therapeutic relationship is focused on the assistance that nurses can and should provide to patients so that they can feel understood and thus be able to work on the discomfort produced by the mental health problem. This was explained through three common themes for nurses and patients: i) acceptance as a means to feel like a person, ii) the nurse's competencies for relating with and accepting others, and iii) the binomial acceptance-therapeutic bond. In order to facilitate the acceptance of others, a process of adaptation is required that occurs simultaneously with the construction of the bond between both parties during the orientation phase of the therapeutic relationship. Conclusions: Acceptance of the other enables nurses and patients to feel and connect with oneself, facilitating patients in their recovery process and protecting nurses from professional burnout. Relevance to clinical practice: These results can contribute towards the improvement of person-centered care in mental health nursing; individualized care must place the person and their experiences at the center of care.