Nurses’ Perception of Their Competencies in the Provision of Psychiatric Care: A Case of Loitokitok Sub-County Hospital

Abstract

Ideally, psychiatric services are offered by nurses specialized in this area. However, due to the current acute shortage of these experts, deployment of general nurses in caring for clients with mental ailments has become inevitable. Competency in service delivery is either real or perceived. Nurses’ self-perceptions on their know-how to offer services influences their confidence; and ultimately the quality of patient care. However, there is shortage of literature on nurses’ perceived competencies in psychiatric care in Kenya; and particularly in Loitoktok Sub-County Referral Hospital. This is concerning especially since shortage of specialized psychiatric nurses has made it inevitable to deploy general nurses to provide care for the mentally ill. Therefore, the study aim was to assess nurses’ self-evaluation of their competencies in the care of psychiatric patients at Loitokitok Sub County Hospital. The specific research objectives that guided this enquiry were: to assess nurses’ perception on psychiatric assessment in the provision of psychiatric care; to establish nurses’ perception in application of therapeutic Communication in the provision of psychiatric care; to determine nurses’ perception in ability to provide the needed interventions in the psychiatric care; and to determine whether there is an association between nurses’ length of professional experience and perception of their competencies to provide psychiatric nursing care. A cross-sectional study, employing census survey of all the 41 eligible nurses working in the hospital was done. Data was obtained by means of a structured questionnaire. Informed voluntary consent and all other ethical clearances were obtained. The data obtained was analyzed using SPSS version 20.A third of nurses were from maternity department. On gender aspect, female nurses were more than male nurses. Most nurses had strong perceived competency in provision of psychiatric care especially in the area of therapeutic communication. The perceived competency did not significantly differ across the nurses’ qualifications neither did it significantly vary from one department to another. However, the study revealed significant variation in perceived competency across the various years of experience. Moreover, the perceived competency in conducting psychiatric assessment had a significant influence on the ability to provide psychiatric care. Likewise, the perceived intervention competency had an influence on the ability to provide care. However, there was no relationship between perceived communication competency and ability to provide psychiatric care. The study concludes that perceived competency in the provision of psychiatric care is significantly influenced by the nurse’s working experience, perceived competencies in psychiatric assessment and perceived ability to give the needed interventions. Arising from the foregoing findings, this study recommends as follows: regular assessment of nurses’ competencies to form need based capacity building, especially for nurses with more than four years’ experience; and exploring opportunities of encouraging nurses to seek assistance with competencies they have deficiencies in. One such option is to have standby teams for peer-to-peer online anonymous consultations.