The development of a model of emotional support for undergraduate nursing students working in mental health care settings

Abstract

The mental health care environment is a stressful environment because of the environment, perceived unpreparedness of students and the emotional demands placed on the students which are inherent in the nature of the work. The use of the self as a therapeutic tool also presents challenges for students. Whilst researchers have identified supportive interventions and strategies to address students support needs in mental health care settings, these interventions/strategies focus on meeting clinical learning objectives with the assumption that if the student learning needs are met, they will feel emotionally supported. Literature and experience indicates that it is imperative that in this field of study, students should be prepared to cope emotionally with the demands of mental health work. The aim of this research was to develop a model of emotional support for student nurses working in mental health care settings. A theory-generating design based on a qualitative, explorative and descriptive research approach was used to achieve the aim of the study. Purposive sampling was employed to select participants namely: students, educators and clinical staff who met the eligibility criteria. A sample of 40 students, nine educators and nine clinical staff who worked in the four psychiatric hospitals and community mental health clinics in the Western Cape participated in the study. Data collection was by means of focus group interviews (students) and indepth individual interviews (educators and clinical staff). Data was analysed by means of Tesch’s method of content analysis. The model was developed by means of the four steps of the theory generation process. Step one was concept development which consisted of two sub-steps namely concept identification and concept definition. A total of 22 concepts were identified which was further synthesised into six main concepts. The main concepts which were used to develop the model were: positive self-concept; positive work environment; academic and professional development; effective communication; formal and informal supportive interventions and collaboration between the Higher Education Institution and the mental health care setting. Step two of the theory generating process was model development. These main concepts were placed in relation with each other which formed an emotional support model for students working in mental health care settings. Step three was model description. The model was described using the three phases of interpersonal communication namely orientation phase, working phase and the termination phase. A visual application of the model which depicts the main concepts, the process and the context was shown. Step four dealt with the development of the guidelines for the implementation of the emotional support model. A critical reflection of the model was done using five criteria for model evaluation according to Chinn & Kramer. Trustworthiness of the data was ensured by means of applying Guba’ model of truth value, applicability, consistency and neutrality. Reflexivity was used by the researcher to further enhance trustworthiness. Permission to conduct the study was obtained from the relevant authorities. The ethical principles of respect for human dignity, beneficence and justice were applied throughout the study. Limitations were identified and ecommendations for nursing practice, education concluded the study.