Barriers Experienced by Psychiatric Nurses to Facilitate Therapeutic Relationships With Mental Healthcare Users With Dual Diagnosis in a Psychiatric Hospital in South Africa.

Background: Psychiatric nurses are in a unique position to build therapeutic relationships with mental healthcare users with dual diagnoses to foster trust and recovery. However, a dual diagnosis poses barriers to establishing and maintaining a therapeutic nurse-patient relationship.

Aim: The overall aim of this study was to explore and describe barriers experienced by psychiatric nurses to facilitate therapeutic relationships with mental healthcare users with dual diagnosis in a psychiatric hospital in Limpopo province, South Africa.

Design: A qualitative, explorative, descriptive and contextual design was followed.

Method: Semi-structured interviews were conducted with 12 purposively selected participants who cared for mental healthcare users with dual diagnoses. Tech's method of open coding was used to analyse the data.

Findings: Disruptive and disrespectful behaviour and mental healthcare users' substance use during hospitalisation resulted in nurses harbouring ambivalent feelings that impaired therapeutic nurse-patient relationships.

Conclusion: The barriers affecting therapeutic relationships with mental healthcare users with dual diagnosis should be addressed to enhance recovery and treatment compliance.

Recommendations: An integrated approach with the involvement of the interprofessional team, debriefing and training for nurses may help to foster therapeutic nurse-patient relationships, empower nurses and enhance the recovery of mental healthcare users with dual diagnosis.