Mental Health Nursing Research Articles

Effort–reward imbalance and well-being among psychiatric nurses: the mediating role of burnout and decent work

BackgroundPsychiatric nurses face additional challenges due to negative perceptions, workplace violence, and a lack of respect, impacting their well-being and job satisfaction, which are crucial for improving psychiatric care and patient outcomes.ObjectivesThis study aims to examine the relationship between effort-reward imbalance, well-being, burnout, and decent work among psychiatric nurses.MethodsThis study used a cross-sectional design. Data were collected using a convenience sampling method in February 2024 from 397 psychiatric nurses at two psychiatric hospitals in Hangzhou and Huzhou, Zhejiang Province. The Effort-Reward Imbalance Scale, Decent Work Perception Scale, Maslach Burnout Inventory-General Survey, and General Well-Being Schedule Scale were used for data collection. Data analysis was conducted using SPSS 26.0 and the PROCESS macro.ResultsThe study found that effort-reward imbalance among psychiatric nurses was negatively correlated with decent work (r = -0.564, p < 0.001) and well-being (r = -0.541, p < 0.001), and positively correlated with burnout (r = 0.603, p < 0.001). Burnout mediated the relationship between effort-reward imbalance and well-being (95% CI [-0.386, -0.257]), while decent work also served as a mediator (95% CI [-0.100, -0.012]). Additionally, burnout and decent work were found to mediate the relationship between effort-reward imbalance and well-being (95% CI [-0.050, -0.006]).ConclusionThis study highlights the impact of effort-reward imbalance on well-being, confirming that burnout and decent work serve as mediators. Enhancing support, fair compensation, reasonable work schedules, and professional development can promote psychiatric nurses’ perception of decent work and improve their well-being.

The association between the work environment and the fear of COVID-19 experienced by nurses.

The conditions in the workplace have a critical influence on the mental health of nurses and their attitudes toward their job, which may impact patient care. This cross-sectional study aimed to investigate the association between perceptions of the work environment and fear of COVID-19 experienced by nurses. The data were collected using a demographic data form, the Work Environment Scale (WES), and the Fear of COVID-19 Scale. The study was completed with 183 nurses who provide care to COVID-19 patients. The mean scores for the WES and Fear of COVID-19 Scale were 63.59±12.35 and 21.98±8.36, respectively. There was a positive correlation between the points acquired from the "employee fears" section of the WES and the Fear of COVID-19 Scale mean ranks (r = 0.22). There was a weak negative correlation between the Fear of COVID-19 score and the WES "job satisfaction" score (r = -0.214). There was a weak negative correlation between the scores of the Fear of COVID-19 Scale and perceived support at work (r = -0.33) and between the WES scores and weekly working hours (r = -0.27). However, there was a weak to moderate positive correlation between the WES scores and number of days off per week (r = 0.45). Nurses experience a high fear of COVID-19, and a decrease in their attitudes of the work environment was associated with an increased fear of COVID-19. The fear of COVID-19 may be reduced by various interventions to provide support at work and increase nurses' job satisfaction.

Professional Quality of Life Among Mental Health Nurses: A Systematic Review and Meta-Analysis.

The professional quality of life (ProQOL) is increasingly applied to nurses and is a measure of the positive and negative aspects of their work. This systematic review and meta-analysis evaluated the level of compassion satisfaction, burnout and secondary traumatic stress (STS) in empirical studies. Electronic databases Scopus, PubMed and Web of Science were searched on 7th February 2024, and the review followed PRISMA guidelines. The pooled estimate of compassion satisfaction, burnout and secondary traumatic stress mean scores using a random-effects model for meta-analyses was undertaken. R statistical software and the dmetar program were used to execute the analysis. Heterogeneity was evaluated with the I2 statistics, while publication bias was evaluated using Egger's regression test. Twenty-four studies (sample size = 4274) were systematically reviewed and 18 studies (n = 3163) were incorporated into the meta-analysis. Burnout, secondary traumatic stress and compassion satisfaction are found to be at moderate levels in this research. The qualitative analysis informs that variables such as healthy lifestyle, work environment and psychological resilience contribute towards optimum ProQOL scores. The pooled mean estimate was 32.79 (95% CI = 29.57-36) for compassion satisfaction, 24.99 (95% CI = 23.75-26.23) for burnout and 21.99 (95% CI = 18.93-25.06) for secondary traumatic stress, respectively. Mental health nurse managers need to address the factors in the work environment and promote interventions to enhance coping with burnout and STS. Subgroup analyses of country-based economies & regions and years revealed significant results.

Knowledge, Attitude, and Practice of Nursing Staff Toward Patients Who Attempted Suicide at Tertiary Care Hospital of Central Gujarat, India

Background: Looking at the alarming increase in the incidence of attempted suicide worldwide, having adequate expertise in managing people with attempted suicide is imperative. Therefore, healthcare professionals, specifically nurses, must be provided training exclusively on managing patients with attempted suicide and preventing suicide in the near and distant future. Nursing staff play a major role as a point of first contact for suicide survivors, and therefore, it is of utmost importance that they are adequately trained and knowledgeable in this area. To understand their knowledge, the authors decided to do this study to measure knowledge, attitude, and practice (KAP) among nurses in suicide survivors. Aim: The aim of this article was to study the KAP of nursing staff toward patients with suicide attempts. Methods: A hospital-based cross-sectional, quantitative study was conducted among nursing staff. All nurses ( n = 300) were approached in small groups between July and November 2023 via a convenient sampling. Written informed consent from participants was taken. The semi-structured questionnaire included sociodemographic details, their professional experience, their training and experience in managing suicidal patients, and KAP questions. The KAP questions were on patients with suicide attempts and were derived from the suicide knowledge and skill questionnaire (SKSQ), suicide attitude questionnaire, and practice guidelines of the American Psychiatric Nurses Association. Data was analyzed by using MS Excel version 6.2.14. Result: In this study, a total of 200 nursing staff participated. The majority were female (80%), with a mean age of 37 years and a mean professional experience of 12 years. Out of all participants, 68% had experience managing patients with suicide attempts, but only 27% of them were trained in suicide prevention. The mean score of knowledge and attitude among study participants were 65.25/100 and 3.24/5, respectively. Nursing staff had higher scores in questions of suicide risk assessment and statements related to attitudes like “they deserve respect in society.” In practice assessment, more than 80 % of nurses were keenly observant, empathetic, and nonstigmatized for hospitalized patients of suicide attempts. The nurses took measures like restricting access to harmful objects (medicines, sharp objects) and giving medicines under supervision. Conclusion: The nursing staff had adequate knowledge, a nonstigmatized attitude, and appropriate clinical practices toward patients with suicide attempts, but they lacked formal training. So, hands-on training for suicide management at regular intervals is the need of the hour.

How is ‘shortage’ defined? Exploring Nursing Workforce Data across Canada 2015-2022: An Ecological Study

RationaleDetermining the ability of a country’s nursing workforce to meet the health care needs of the population is essential for optimal health outcomes. ‘Nursing shortage’ is frequently heralded as an issue, yet it is unclear how ‘shortage’ is defined and calculated. The purpose of this study was to collect and link publicly available Canadian data to describe and compare trends in nursing workforce capacity. MethodsPrimary data sources included linking Statistics Canada and Canadian Institutes of Health Information (CIHI) data from 2015 to 2022. Statistics Canada tracks provincial population data and job vacancy rates. CIHI receives data from provincial nursing organizations on demographics, roles, and employment status. To estimate a sufficient workforce, job vacancy rates (a proxy for provincial need) were cross tabulated with the number of registered nurses (RNs) and registered psychiatric nurses (RPNs) per year. ResultsThe number of RNs and RPNs in Canada has increased by 8.6% between 2015 and 2022, to a total of 322,226. Job vacancies, as a percent of total nursing supply, shows a rising trend (2.3% to 8.7%) between 2015 and 2022 across Canada. In 2022, 84.9% of Canadian RNs and RPNs in direct patient care across Canada and 86.1% were in urban settings. Conclusion &amp; LimitationsThis project examines Canadian nursing workforce data encompassing potential effects of the COVID-19 pandemic. The trends are limited to annual due to aggregated data. Data on a country’s nursing workforce measured monthly and consistently across provinces would yield clearer information.

Experiences of Mental Health Nurses in Providing Care to Patients Receiving Electroconvulsive Therapy in South Korea.

In recent years, the demand for electroconvulsive therapy has been increasing in South Korea. However, there are problems due to mental health nurses' lack of understanding about electroconvulsive therapy and the absence of systematic education. This study aimed to explore mental health nurses' experiences of providing care to patients receiving electroconvulsive therapy in South Korea. We used content analysis to analyse the data collected from focus group interviews with 22 mental health nurses working in mental health hospitals. The results revealed four themes and 10 subthemes. More specifically, the results showed that mental health nurses consider themselves helpers in recovery. They pursue the physical and emotional well-being of patients receiving electroconvulsive therapy and strive to ensure that patients receive electroconvulsive therapy comfortably and safely. However, contentious issues such as concerns about patient dignity and autonomy lead to differing perceptions and attitudes towards electroconvulsive therapy and cause internal conflict during therapeutic interactions. Furthermore, insufficient education on electroconvulsive therapy leads to a lack of knowledge and difficulties in fulfilling the role of an information provider. The shortage of coping measures and support systems for issues such as extensive adverse effects and restricted medication increases the work burden immensely. These findings can serve as foundational data for the development of standardised nursing practices and systematic education for electroconvulsive therapy.

O le Fau Gagana: A Samoan Mental Health Nurse in Aotearoa-New Zealand.

This article explores my journey as a Samoan woman who migrated as a young mother to Aotearoa-New Zealand, completed nursing qualifications, later specialising in mental health nursing, and eventually completed doctoral studies. Since July 2023 I have been a Lecturer in the Department of Nursing, Faculty of Health and Environmental Studies, Auckland University of Technology. This article uses autoethnographic and narrative methods to collect data from my own life, to explore the experiences of Samoan people in the mental health system of Aotearoa-New Zealand. Criteria for reporting qualitative research was used to prepare the paper. My story showcases the benefits of having both clinical and cultural understandings in the context of mental health care in Aotearoa-New Zealand. The gap between the rhetoric and the reality of the 'New Zealand dream' for Samoan people mirrors the gap between policy and practice in relation to Pacific strategy plans for mental health care. By writing about my experiences, I aim to support better understanding of core concerns for Samoan people when they are engaging with mental healthcare services.

Relationships Among Secondary Traumatic Stress, Mindfulness, Compassion Satisfaction, and Compassion Fatigue in Psychiatric Nurses.

To examine relationships among secondary traumatic stress, mindfulness, compassion satisfaction, and compassion fatigue in psychiatric nurses. Participants comprised 142 nurses working in two psychiatric hospitals in the same province of Turkey. Data were collected using a personal information form, the Secondary Traumatic Stress Scale, Mindful Attention Awareness Scale, and Compassion Fatigue and Compassion Satisfaction subscales of the Professional Quality of Life Scale. A significant and negative correlation was found between secondary traumatic stress, mindfulness, and compassion satisfaction, and between mindfulness and compassion fatigue. A significant and positive correlation was found between secondary traumatic stress and compassion fatigue, as well as between mindfulness and compassion satisfaction (p < 0.05). Findings demonstrate that mindfulness may be a protective factor in preventing secondary traumatic stress and compassion fatigue in psychiatric nurses. It is recommended that in-service training be organized periodically to increase levels of conscious awareness among psychiatric nurses. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Training Nurses in Trauma-Informed Care to Address Workplace Violence in Inpatient Settings.

Frontline workers in psychiatric facilities are exposed to considerable risks of verbal and physical assaults, with 40% to 65% of mental health nurses experiencing violence in the workplace. The goal of this pilot study was to assess the readiness and motivation for adopting trauma-informed care (TIC) to address workplace violence in an acute care psychiatric hospital. A pre-post quality improvement study was conducted in two pilot units of a 274-bed acute care psychiatric hospital, involving a discussion-based seminar and a practical exercise. Surveys assessed participants' readiness and motivation posttraining. Sixty-eight staff members completed part 1 training, with 63 (92.6%) reporting being prepared to use TIC principles afterward. All 14 staff members (100%) who completed part 1 and part 2 training reported being motivated to apply the TIC model after the intervention. The results show that TIC training may impact self-reported strategies for reducing workplace violence. Education in trauma-informed care may prove to be beneficial in providing nurses with the necessary skills to effectively implement TIC principles in their daily practices. [J Contin Educ Nurs. 2024;55(10):472-478.].

The role of mental health in the relationship between nursing care satisfaction with nurse-patient relational care in Chinese emergency department nursing.

The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse-patient relational care and nursing care satisfaction. A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale. Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419-0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298-0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032-0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057-0.172 and 0.057, 0.347-0.493). This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services.

FC51: A Big BIT: Utilizing Behavioral Intervention Team Approaches to Improve the Care of Older Adults on Med-Surg Units

Background: Older adults may exhibit behavioral disturbance while medically hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events including falls, elopements, or violence. The traditional consultation-liaison model addresses challenging or high-risk behaviors but is often reactive and may lead to missed opportunities. The interdisciplinary Behavioral Intervention Team (BIT) was implemented on the campus of Prisma Health Baptist Hospital in Columbia, SC to address and anticipate the need for behavioral health support on medical units.Methods: A pilot BIT program was implemented in September 2019. Two psychiatric nurses were embedded on med-surg units as a part of medical and psychiatric interdisciplinary teams. After obtaining approval from the Prisma Health Institutional Review Board, a retrospective review was conducted to evaluate the correlation between BIT interventions and patient safety events. Two time periods were examined: six months with early-BIT efforts and six months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated p- values (p &lt; 0.05).Results: Of admitted patients during the study period (N = 1413), almost half were age 65+. Pre- existing psychiatric diagnoses were present in 58% of cases with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% vs 61.3%, p &lt; 0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% vs 2.3%, p &lt; 0.001), use of restraints (5.8% vs 3.4%, p = 0.034) and need for security (4.2% vs 0.8%, p &lt; 0.001) were observed. Geriatric subgroup analysis demonstrated a significant decrease in the need for security only (4.6% vs 0.6%, p &lt; 0.001).Conclusions: Engaging BIT significantly reduced aggression, restraint use, and security interventions. As psychiatric comorbidities continue to impact overall treatment plans, care teams will need to prevent high-risk behaviors and events. Implementing an interdisciplinary BIT is feasible and effective in reducing negative outcomes.

Psychotherapy Skills for Psychiatric Mental Health Nurse Practitioner Students in the Age of Competency-Based Education.

As the field of nursing moves toward competency-based education, faculty need to adapt teaching and learning strategies to meet standards for assessing core behaviors of graduate psychiatric mental health nurse practitioner students. This article reviews a psychotherapy skills-based learning assignment at Frontier Nursing University that was adapted to meet developing competency-based learning standards. The assignment utilizes prerecorded video scenarios to provide students with opportunities to reinforce psychotherapy skills during didactic coursework. Assessment is conducted via an analytic rubric and specific feedback is given to each student in writing.

Associations between individual and social stigma perception and burnout levels in Italian mental health nurses: an exploratory study

Associations between individual and social stigma perception and burnout levels in Italian mental health nurses: an exploratory study

The Use of Nursing Theory and Model in Mental Health and Psychiatric Nursing Doctoral Theses: Turkiye Sample

Aim: The aim of this study is to identify nursing models used in doctoral theses in psychiatric and mental health nursing. Material and Methods: In this descriptive-type retrospective document analysis study, theses in mental health and psychiatric nursing departments of health sciences institutes were reviewed at the National Thesis Center of the Council of Higher Education on from September to October 2023. The study was completed with 14 doctoral theses. Word and Excel programs were used to record and analyze data. Results: The Roy Adaptation Model and then the Neuman Systems Model were mostly used in doctoral theses. It was determined that four theses were randomized controlled, and six theses were done within the scope of community mental health nursing when the sample group was examined. Conclusions: The Roy Adaptation Model has positive effects on issues such as emotional expression, self-esteem, and treatment areas. As a sample group, there was a tendency towards preventive mental health services. Experimental designs with control groups were used in doctoral theses, and four theses were determined to be randomized controlled.

Understanding the experiences of transition for newly qualified mental health nurses and their potential to stay in the role: A qualitative exploration

AimTo understand the experiences of transition from the perspective of newly qualified mental health nurses and the impact this may have on their potential to remain in the role. BackgroundDuring the transitional period following registration newly qualified nurses experience feelings of being overwhelmed and shock. Internationally there is limited research on factors influencing transitional experiences in the field of mental health. DesignA qualitative exploration was conducted using thematic content analysis to analyse the data gathered from semi-structured interviews Method18 Newly qualified mental health nurses from two NHS Mental Health trusts were interviewed, all within 18 months of registration. Data were analysed and themes generated addressing the research aim. Results/Findings:Five themes were co-created using this inductive technique: ‘Transition to new role’, ‘Support for new role’, ‘Professional identity’, ‘Role development’ and ‘Working environment’. These themes are representative headings with the sub-themes making up the contributory content. Themes highlighted issues concerning newly qualified nurses and the transition which included aspects of anxiety and feeling overwhelmed initially. This highlighted the feelings associated with transition and progression through the process of liminality. Supervision was identified in the context of formal support, the presence of which is conducive to a positive transition. Imposter syndrome and experiencing reality shock were common aspects of role development and acknowledging the sense of responsibility gained once registered. Safety was highlighted as many experienced their first role on in-patient environments which was busy and potentially hostile. ConclusionThe transition of newly qualified nurses in mental health services can prove to be a difficult experience, therefore it requires acknowledgment and careful consideration. Understanding the liminal process may allow staff to appreciate the effect of the transition and to understand that the NQN will face overwhelming and unfamiliar responsibilities. Despite the demands to boost the workforce in mental health services there is a need to understand how best to integrate NQN’s into their role during this transition. Caution must be used if we are not to lose more NQN’s, as despite concerns there are still NQN’s looking to mental health nursing as their future and chosen career.

Stepping Up Psychosis: The Use of Virtual Reality in Pre-registration Mental Health Nursing Education

BackgroundThere has been growing interest in the development of mental health-related simulation packages for pre-registration mental health nursing education. The authors will present the creation of a simulation package created for pre-registration mental health nurses during their final year. MethodThe simulated experience consisted of a five-minute Virtual Reality (VR) recording which shares the experience of living with symptoms of psychoses. The package, not only looked at the hearing of voices, but in addition enhances the user's experience by simulating visual perception and placing the student within a secluded environment. This was delivered to students in their final six months of the program. ResultsStudents noted the increase in empathy for patients experiencing these symptoms and how it would enhance the care they gave. ConclusionThe results of this innovation demonstrate how virtual reality (VR) could be used to standardize student nurses' education in the field of mental health.

Identifying Nursing Students' Views of Studying Mental Health and Diseases Nursing Course via Distance Education during the Pandemic

Objective: This research was conducted to determine students' opinions about taking the mental health and disease nursing course through distance education. Methods: The research, designed as a descriptive quantitative study, and conducted with students (n=243) taking the Mental Health and Disease Nursing course at the Nursing Department of a state university in Ankara. "Participant Information Form", " Assessment Form for Mental Health and Diseases Nursing Course Distance Education," created by the researchers, and the "Opinions About Distance Education Scale" were used to collect the data. In data analysis, content analysis was performed for open-ended questions, and the data were presented under themes, sub-themes, and categories. Number, percentage, mean, standard deviation, median, minimum, and maximum values were given for the scale scores. Results: The views of students on distance education were conceptualized under four themes: "Views on distance education", "Effectiveness of teaching methods used", ''Effectiveness of methods used in the practice skill courses, ''Preparedness for provide nursing care to patients followed up with a psychiatric diagnosis.' The total mean score of the participants for the opinions about the distance education scale was determined as 2.91±0.48. Conclusion: The students evaluated the education provided through distance education as moderately sufficient. The teaching methods used in the mental health and diseases nursing course taken through distance education and ensuring permanence through repeated access to courses were stated as positive aspects in theoretical terms, significant deficiencies were expressed in terms of contacting patients in the clinical environment and gaining professional roles.

Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.

INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.

The Memoir of a Ghost: The Invisible Plight of Mental Health Nurse Education in the United Kingdom Following the Nursing and Midwifery Council's Move Towards Genericism.

The aim of this paper is to identify barriers to quality mental health nurse education in the United Kingdom and show these through the sharing of personal experiences of working as a mental health nurse academic. Since the Nursing and Midwifery Council introduced their 'future nurse' education standards in 2018, mental health content for mental health nurses has been argued to have been marginalised. The sense of a diluted mental health nurse education was supported by an open letter, signed by over 100 mental health nurses, with representation across 33 universities. Nonetheless, the approach taken by the NMC has been defended. Meanwhile, mental health nurse academics all over the United Kingdom are having varying experiences, some of incredible discomfort and invalidation. The movement 'mental health deserves better' arose through many of these mental health nurses feeling they had no representation or channel to voice their concerns. This is a personal position paper which outlines barriers to autonomy for mental health nurse academics, and shares personal opinion on experiences which have impacted the ability to deliver a depth of knowledge, skill and critical thinking to students, impacting the quality of new mental health nurse graduates. The issue is discussed using contemporary literature to support lines of argument, which are augmented by personal experiences of working in nurse education. There are complex interconnected issues within nurse education which can hinder the autonomy of mental health nursing to decide its own future. This paper recounts a personal journey. Often we cannot understand the failings of a system until we try to navigate it from the inside.

A qualitative study of hermeneutic analysis in individuals with schizophrenia, psychiatrists and psychiatric nurses writings on selected narratives.

INTRODUCTION: Understanding individuals with schizophrenia is an essential but challenging phenomenon in psychiatry. This study proposes a reevaluation of the nature of therapeutic communication among individuals with schizophrenia, psychiatrists and psychiatric nurses by interpreting their writings on the same written narratives through a hermeneutic analysis. In this study, employing a qualitative descriptive methodology utilising hermeneutic analysis, participants read the five narratives, wrote down their opinions on each narratives and answered nine questions to express their own personal writing experiences. Participants from each group acted as both 'readers' and 'authors' while rewriting the selected five short narratives based on their own sense of readings. The expression, rewriting refers to the act of reading and written interpretations of participants and researchers in this study. While individuals with schizophrenia primarily focused on the text (narrative) in their readings and writings, psychiatrists and psychiatric nurses tended to focus on reader (themselves) in their interpretations. Although reading should be approached as a process of discovery rather than merely seeking predetermined knowledge, psychiatrists and psychiatric nurses read the narratives as if the author were a patient or as the signs of an illness. The results point to the need for psychiatrists/psychiatric nurses to develop new perspectives and skills in understanding and interacting with individuals with schizophrenia.