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Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis

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  • Maki Miou

    (Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan
    Faculty of Nursing, Osaka Shin-Ai Gakuin University, 6-2-28 Tsurumi, Tsurumi-ku, Osaka 5380053, Japan)

  • Hirokazu Fujimoto

    (Faculty of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe 6508530, Japan)

  • Kayano Yotsumoto

    (Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan)

  • Misato Hirota

    (Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan)

  • Satoshi Nishigaki

    (School of Nursing, Takarazuka University, 1-13-16 Shibata, Kita-ku, Osaka 5300012, Japan)

  • Takeshi Hashimoto

    (Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan)

Abstract

The phenomenon of some patients with schizophrenia withdrawing and becoming hikikomori needs to be resolved. In some countries, outreach methods are being employed. In Japan, psychiatric home-visit nursing for patients with schizophrenia and hikikomori is being implemented. However, it is not based on sufficient evidence and relies on the experience and intuition of individual nurses. This study explored the underlying themes in the nursing practices of psychiatric home-visit nurses via semi-structured interviews with 10 nurses and a thematic analysis. Nine key themes emerged. Four themes—(i) understanding the patient’s world, (ii) supporting the patients as they are, (iii) providing a sense of relief, and (iv) having equal relationships—highlighted the nurses’ commitment to respecting patients’ individuality while building and sustaining relationships. Two themes—(v) exploring the right timing and (vi) waiting for the appropriate timing—illustrated the nurses’ anticipation of proactive patient engagement. Finally, three themes—(vii) working together on things, (viii) continuing care for expanding the patient’s world, and (ix) nursing care for the patient’s future—underscored the nurses’ gradual and methodical approach to working alongside patients. Nursing practices based on these nine themes cultivated meaningful relationships and secured a sense of relief for the patients. Additionally, they awaited patients’ proactive engagement and delivered timely support to facilitate positive daily life changes. These findings contribute to the establishment of evidence-based nursing practices for patients with schizophrenia and hikikomori.

Suggested Citation

  • Maki Miou & Hirokazu Fujimoto & Kayano Yotsumoto & Misato Hirota & Satoshi Nishigaki & Takeshi Hashimoto, 2024. "Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis," IJERPH, MDPI, vol. 21(2), pages 1-13, February.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:2:p:181-:d:1333833
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    References listed on IDEAS

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    1. Michelle Jin Yee Neoh & Alessandro Carollo & Mengyu Lim & Gianluca Esposito, 2023. "Hikikomori: A Scientometric Review of 20 Years of Research," IJERPH, MDPI, vol. 20(9), pages 1-19, April.
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