Transforming nurse-patient relationships-A qualitative study of nurse self-disclosure in mental health care

Abstract

Aims and objectives: To describe what and why nurses self-disclose to patients in mental health care.

Background: Self-disclosure is common, but controversial and difficult to delineate. Extant research suggests that self-disclosure might have several potentially beneficial effects on therapeutic alliance and treatment outcome for patients in mental health care, but results are often mixed and limited by definitional inconsistencies.

Design: Multi-site study with purposive sampling and source triangulation.

Method: Qualitative descriptive study including data from 16 nurses taking part in participant observation, individual interviews and focus group interviews.

Results: Separate analyses resulted in four themes addressing the research question of what nurses self-disclose, and one main theme and four subthemes addressing why nurses self-disclose. The content of self-disclosure was captured in the four themes: Immediate family, Interests and activities, Life experiences and Identity. In addition, results showed that disclosures were common among the nurses. Self-disclosure's potential to transform the nurse-patient relationship, making it more open, honest, close, reciprocal and equal, was the overarching reason why nurses shared personal information. The nurses also chose to self-disclose to share existential and everyday sentiments, to give real-life advice, because it felt natural and responsive to patients' question to do so.

Conclusion: Nurse self-disclosure is common and cover a variety of personal information. Nurses have several reasons for choosing to self-disclose, most of which are connected to improving the nurse-patient relationship.

Relevance to clinical practice: Self-disclosure controversy can make it difficult for nurses to know whether they should share personal information or not. Insights into the diversity of and reasons for nurse self-disclosure can help with deliberations on self-disclosure.

Keywords: mental health nursing; nurse-patient relationship; professional boundaries; qualitative study; therapeutic relationships.