The aim of this study was to identify strategies to improve the quality of psychosocial care given by nurses in medical units in the tertiary hospital. A participatory action research framework was adopted. Data were collected through interviews, focus groups, observations and a review of nursing documents. Thematic qualitative analysis was used for the analysis and inter-pretation of the data.
The project was divided into three phases. First, a reconnaissance phase, which aimed to identify barriers in the provision of psychosocial care and opportunities to overcome these constraints as evidenced by heavy workload and caseload, time constraint, ward culture, a lack of knowledge. In the action phase, 10 nurses from each ward volunteered to participate in negotiating to improve the quality of psychosocial care (total n=30). An aim was to improve care by capacity building with the group through a number of work-related systems. These actions included building up capacity through psychosocial workshops, holding case conferences, developing a primary psychosocial nursing care model and also a nursing work sheet, creating psychosocial environment, and a casting psychosocial nurse award.
The evaluation phase, indicated varying degrees of positive changes in the nurse's practices, particularly in their awareness and understanding of the job and patients, including establishing networking in psychosocial care, understanding themselves and among their colleagues, increasing nursing records related to psychosocial care, knowing their patients better, providing more holistic care to their clients, increasing the awareness of autonomy in their professional role and job satisfaction, and finally creating nursing project to improve psychosocial and spiritual care. Factors that influenced the sustainability of psychosocial activities were promoting both self-awareness and a professional role while continuously supporting activities to develop psychosocial care as well as developing the organization system.
The project shows that the activities introduced have now empowered the nurses to share their knowledge and experiences which was applied toward action for positive change and finally brought about. This has resulted in the improvement in the quality of patient care.