Student mental health nurses' understanding of recovery: A phenomenographic study.

ABSTRACT

AIM: To explore the variation in mental health nursing students' understanding of recovery. BACKGROUND: In mental health practice clinical understanding of recovery has been challenged with a new understanding based on the individualised experiences of the person, often referred to as personal recovery. Despite international policy endorsement, practice has been slow to embrace the principles of personal recovery and little is known about student nurses' understanding of the concept. DESIGN: Qualitative phenomenographic study METHOD: In-depth semi-structured interviews including discussion of a clinical scenario, were conducted with 13 pre-registration student nurses. Data was analysed iteratively using a seven stage phenomenographic framework, identifying categories of description and the outcome space. RESULTS: Analysis revealed a branched outcome space with four qualitatively distinct ways of understanding recovery. Branch one can be broadly aligned to clinical recovery and contains one category only, 'Recovery as Clinical Improvement'. It is distinctly different from branch two which contains three categories on a continuum, which represent more and less complete ways of understanding personal recovery 'Recovery as Making Progress', 'Recovery as Managing to Live Well' and 'Recovery as Learning to Live Differently'. Most participants demonstrated understanding in the less sophisticated categories. CONCLUSION: Recovery is central to mental health nursing, yet this study suggests it is a problematic concept for students. Features of personal recovery can be found in the second branch of the outcome space, with the most sophisticated category 'Learning to Live Differently' best representing the principles of recovery espoused in nursing literature and international policy. Phenomenography has allowed a more complex picture to emerge, replacing the dichotomy between clinical and personal recovery and enabling a differentiation between more and less complete ways of understanding personal recovery. This study addresses the lack of attention given to student nurse experiences of recovery. The insights support educators, both in clinical and academic settings, to address personal recovery in more explicit way where partial understanding can be explored.