District nurses’ experiences of giving initial health care assessment to young adults applying for mental illness in primary care: a qualitative interview study

Abstract

Mental illness among young adults is increasing both nationally and internationally. Primary care's mission is to be the hub of health care and to offer high-quality care regardless of age, patient group, or disease. The role of district nurse varies in terms of definition and scope of practice but has a central role through their health promotion mission and by being the first person these young adults meet in primary care. The aim of this study was to explore district nurses' experiences of meeting young adults with mental illness in primary care. The study was conducted with a qualitative inductive approach. Data were collected through semi-structured interviews with nine district nurses in primary care in Sweden. The data were analysed through qualitative content analysis. Three categories emerged in the results - The difficult meeting, The district nurse's ability to promote health, and A sense of inadequacy. The results show that district nurses can experience feelings of stress and frustration when time, resources, and knowledge are lacking. Continuous training in mental illness was desired by all district nurses. Listening, confirming, and daring to ask were highlighted as particularly important in the meeting with young adults. Cooperation between different professions and colleagues was highlighted as a prerequisite for the provision of good quality care. To meet the increasing number of young adults with mental health problems seeking care, district nurses in primary care need continuous training. By working in a person-centred and health-promoting manner, the district nurse's competence can be utilized. The district nurses perceive they could manage the important role being a resource and take a greater responsibility to guide young adults on the right path.