Nurses' Perceptions of Patients With Co‐Occurring Psychiatric and Substance Use Disorders in Psychiatric Settings: A Grounded Theory Study

AIM: To explore psychiatric and mental health nurses' perceptions of patients with co-occurring psychiatric and substance use disorders in psychiatric settings. DESIGN: An exploratory qualitative study design based on grounded theory, employing Straussian analytic procedures. METHOD: Semi-structured interviews were conducted with 11 psychiatric and mental health nurses. Participants were recruited at a public psychiatric hospital located in the Paris metropolitan area of France. Face-to-face interviews took place between February 2024 and May 2024. Field notes and interview data were continuously analysed during open, axial and selective coding phases. RESULTS: The core category identified was 'waiting for a patient's will to change to emerge' when caring for patients with co-occurring substance use disorders. This active waiting period involved a balancing strategy between two discrete care objectives: stabilising the patient's clinical status and keeping the nurse-patient relationship intact. Identifying a patient's will to change provided an opportunity to reconcile these two aspects of psychiatric nursing through the addition of a collaborative component to the relationship. CONCLUSION: The substantive theory generated by our findings contributes to understanding the interactional and relational processes that occur between nurses and patients presenting with co-occurring substance use disorders in the context of psychiatric care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Implications of our study include the need for further emphasis on collaborative approaches that can be applied even in early or pre-contemplative stages of recovery. Organisational policies should systematically include training in the field of addiction care, given the high prevalence of co-occurring substance use disorders in psychiatric settings. IMPACT: Our findings can assist nurses in critically examining the challenges they experience when engaging with patients with co-occurring substance use disorders. REPORTING METHOD: This research adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.