The barriers to therapeutic communication in psychiatric wards: a focused ethnography

Abstract Background and aim Identifying the influential factors affecting effective nurse-patient communication in psychiatric wards may facilitate the development of strategies to enhance communication. The aim of this study was to explore the barriers to therapeutic communication (TC) in psychiatr...

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Main Authors: Zahra Raisi, Sedigheh Khodabandeh Shahraki, Behnaz Bagherian, Nahid Dehghan Nayeri
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Nursing
Subjects:
Online Access:https://doi.org/10.1186/s12912-025-03690-w
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author Zahra Raisi
Sedigheh Khodabandeh Shahraki
Behnaz Bagherian
Nahid Dehghan Nayeri
author_facet Zahra Raisi
Sedigheh Khodabandeh Shahraki
Behnaz Bagherian
Nahid Dehghan Nayeri
author_sort Zahra Raisi
collection DOAJ
description Abstract Background and aim Identifying the influential factors affecting effective nurse-patient communication in psychiatric wards may facilitate the development of strategies to enhance communication. The aim of this study was to explore the barriers to therapeutic communication (TC) in psychiatric wards. Methods This qualitative study was conducted in 2022 using Spradley’s focused ethnography. Participants included 32 nurses, auxiliary nurses, psychologists, physicians, nursing managers, patients, and patient companions purposively selected from the emergency wards of a psychiatric hospital in Iran. Data were collected through observations, interviews, field notes, and fieldwork journals and were analyzed using Spradley’s method. Findings Four main cultural themes emerged from the 47 codes on TC barriers in psychiatric wards: different worlds of care, inappropriate portrayals of clinical interactions with patients, stressful care environments, and sociocultural norms. These cultural themes encompassed twelve cultural components. Conclusion A broad range of nurse-related, patient-related, environmental, and sociocultural factors may act as barriers to TC in psychiatric wards. Study findings can be utilized to develop strategies for managing the barriers to TC in psychiatric wards.
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spelling doaj-art-9ae3d014a84e4d5083c4d5f31c5cda172025-08-20T04:01:56ZengBMCBMC Nursing1472-69552025-08-0124111110.1186/s12912-025-03690-wThe barriers to therapeutic communication in psychiatric wards: a focused ethnographyZahra Raisi0Sedigheh Khodabandeh Shahraki1Behnaz Bagherian2Nahid Dehghan Nayeri3Student Research Center, School of Nursing and Midwifery Razi, Kerman University of Medical SciencesStudent Research Center, School of Nursing and Midwifery Razi, Kerman University of Medical SciencesStudent Research Center, School of Nursing and Midwifery Razi, Kerman University of Medical SciencesSchool of Nursing and Midwifery, Tehran University of Medical SciencesAbstract Background and aim Identifying the influential factors affecting effective nurse-patient communication in psychiatric wards may facilitate the development of strategies to enhance communication. The aim of this study was to explore the barriers to therapeutic communication (TC) in psychiatric wards. Methods This qualitative study was conducted in 2022 using Spradley’s focused ethnography. Participants included 32 nurses, auxiliary nurses, psychologists, physicians, nursing managers, patients, and patient companions purposively selected from the emergency wards of a psychiatric hospital in Iran. Data were collected through observations, interviews, field notes, and fieldwork journals and were analyzed using Spradley’s method. Findings Four main cultural themes emerged from the 47 codes on TC barriers in psychiatric wards: different worlds of care, inappropriate portrayals of clinical interactions with patients, stressful care environments, and sociocultural norms. These cultural themes encompassed twelve cultural components. Conclusion A broad range of nurse-related, patient-related, environmental, and sociocultural factors may act as barriers to TC in psychiatric wards. Study findings can be utilized to develop strategies for managing the barriers to TC in psychiatric wards.https://doi.org/10.1186/s12912-025-03690-wFocused ethnographyPsychiatric wardTherapeutic communication
spellingShingle Zahra Raisi
Sedigheh Khodabandeh Shahraki
Behnaz Bagherian
Nahid Dehghan Nayeri
The barriers to therapeutic communication in psychiatric wards: a focused ethnography
BMC Nursing
Focused ethnography
Psychiatric ward
Therapeutic communication
title The barriers to therapeutic communication in psychiatric wards: a focused ethnography
title_full The barriers to therapeutic communication in psychiatric wards: a focused ethnography
title_fullStr The barriers to therapeutic communication in psychiatric wards: a focused ethnography
title_full_unstemmed The barriers to therapeutic communication in psychiatric wards: a focused ethnography
title_short The barriers to therapeutic communication in psychiatric wards: a focused ethnography
title_sort barriers to therapeutic communication in psychiatric wards a focused ethnography
topic Focused ethnography
Psychiatric ward
Therapeutic communication
url https://doi.org/10.1186/s12912-025-03690-w
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