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

Maki Miou (), Hirokazu Fujimoto (), Kayano Yotsumoto, Misato Hirota, Satoshi Nishigaki and Takeshi Hashimoto
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Maki Miou: Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, 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

IJERPH, 2024, vol. 21, issue 2, 1-13

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.

Keywords: hikikomori; home-visit nursing; schizophrenia; nursing practice; qualitative research; thematic analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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