Schizophrenia and cancer: Insights into psychiatric nursing care

INTRODUCTION: Few studies have applied Benner's nursing theory in evaluating psychiatric nursing care for patients with schizophrenia and the complication of cancer. Further study and training are needed in the management of these diseases.

OBJECTIVES: (1) To elucidate and categorize psychiatric nursing expertise in schizophrenia and cancer according to the five stages of Benner's nursing theory. (2) To identify stage-specific learning needs for the psychiatric nursing care of schizophrenia and cancer, and to propose tailored educational programs. (3) To clarify the differences in the roles and training of psychiatric nurses in Malaysia and Japan.

METHODS: A qualitative descriptive design was adopted. Semi-structured interviews were conducted with a total of 20 psychiatric nurses in Malaysia and Japan. The data were thematically analyzed and categorized with Benner's theory.

RESULTS: Benner's five stages of proficiency were: Novices followed pre-established routines; advanced beginners focused on psychiatric symptoms and behavior; competent nurses determined and prioritized methods of care; proficient nurses flexibly adjusted care to the patient's condition; and experts lent extensive experience to the team and patients. The following learning needs were identified: Novices struggled with identifying physical and psychiatric symptoms; advanced beginners had difficulties understanding ambiguous patient statements; competent nurses needed to improve emergency response skills; proficient nurses faced ethical challenges; and experts sought to pass on their knowledge. Stage-appropriate educational programs, such as a Visual Pain and Psychiatric Symptoms Evaluation Sheet, were proposed accordingly.

DISCUSSION: Further investigations should assess the effectiveness of these educational programs, Japanese-Malaysian cultural differences, and psychiatric liaison nursing.