Skills and Resources of Psychiatric Mental Health Nurses to Support a Long and Uncertain Recovery Journey - A Grounded Theory Approach

Sep 29, 2026

Recovery-focused practice is widely valued, yet little is known about how psychiatric mental health nurses sustain reflective and creative engagement in long-term, complex, uncertain care contexts. This grounded theory study analyzed data from 14 interviews to explore recovery-oriented nursing for people with mental illness in such settings. Findings center on “redefinition of care,” involving shifting understanding, adjusting perspectives, and developing new meanings to manage burden, explore contexts, and stay open to uncertainty.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Aim

Method

Results

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Limitations

Implications

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Accessible Summary

Journal of Psychiatric and Mental Health Nursing ORIGINAL ARTICLE OPEN ACCESS Skills and Resources of Psychiatric Mental Health Nurses to Support a Long and Uncertain Recovery Journey: A Grounded Theory Approach Ryo Odachi1,2 | Hironori Yada3 | Keiichiro Adachi3 | Momoko Buyo1 1Division of Health Sciences, Graduate School of Medicine, The University of Osaka, Suita, Japan | 2Faculty of Human Health Sciences, Shunan University, Shunan, Japan | 3Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube City, Japan Correspondence: Ryo Odachi ([odachi@sahs.med.osaka-u.ac.jp](odachi@sahs.med.osaka-u.ac.jp); [odachi24@shunan-u.ac.jp](odachi24@shunan-u.ac.jp)) Received: 17 July 2025 | Revised: 6 November 2025 | Accepted: 20 November 2025 Keywords: long-term care | mental health services | persons with psychiatric disorders | psychiatric nursing | uncertainty ABSTRACT Introduction: The importance of recovery-focused practice is widely recognised. However, limited attention has been paid to how nurses continue to engage reflectively and creatively in long-term care settings. Aim: This study explored how nurses provided recovery-oriented care for people with mental illness in long-term, complex, and uncertain care settings. Method: A grounded theory approach was used to analyse data from 14 interviews. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results: The core category identified was ‘redefinition of care’, describing a dynamic process in which nurses revised their understanding, adjusted their perspectives, and created new meanings in practice. Key strategies included burden management, exploring new contexts and openness towards uncertainty. Discussion: The findings suggest that high-quality care provision extends beyond technical skills, to emotional resilience, interpretive openness and relational flexibility. Limitations: This study used nurses' retrospective narratives of past cases where recovery progressed. Ongoing cases were not explored. Implications: Nurses could remain present and responsive even with no immediate solutions, a trait described as ‘negative capability’. Supporting this reflective stance may be key to providing quality care. Recommendations: Educational approaches potentially strengthening recovery-oriented care include participatory workshop opportunities that foster pluralistic thinking, dialogue and openness towards uncertainty. 1 | Introduction Over many years, mental health care practitioners and providers have made efforts to move towards a ‘recovery-oriented’approach, emphasising personal and unique values and goals rather than the traditional ‘medical model’ characterised by paternalistic care and symptom management (Le Boutillier et al. 2011; Leamy et al. 2011) . This change includes long-term mental health care (Kidd et al. 2014; Killaspy and Priebe 2021; Waldemar et al. 2016) . Several initiatives have been described, including systematic care models, defined as organised and structured frameworks of care delivery where procedures, responsibilities, and multidisciplinary collaboration are clearly delineated and managed within institutional systems (Kalisova et al. 2018; Zomer et al. 2024) . Other studies have described efforts to reduce seclusion periods using This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd. 140 Journal of Psychiatric and Mental Health Nursing, 2026; 33:140–152 [https://doi.org/10.1111/jpm.70071](https://doi.org/10.1111/jpm.70071) Accessible Summary Originality: • We examined the approaches used by psychiatric nurses to support patient recovery in long-term mental healthcare settings. • This study drew on

FAQs

What was the aim of this grounded theory study?

The study explored how nurses provided recovery-oriented care for people with mental illness in long-term, complex, and uncertain care settings.

What core concept did the researchers identify?

The core category was “redefinition of care,” describing a dynamic process where nurses revise understanding, adjust perspectives, and create new meanings in practice.

What does “negative capability” mean in the study’s implications?

It refers to nurses remaining present and responsive even without immediate solutions, supported by a reflective stance that helps maintain care quality.

Sep 29, 2026

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