Competencies of Nurse Assistants under the Supervision of Registered Nurses in Caring for Psychiatric Patients and Patients with Substance Abuse in a Multicultural Context

Abstract

This qualitative research aimed to study the competencies of nurse assistants in caring for psychiatric patients and patients with substance abuse under the supervision of professional nurses in Thailand’s southern border provinces. A total of 30 participants were purposively selected, including 10 professional nurses, 10 nurse assistants, and 10 lecturers in mental health and psychiatry. Data were collected through interviews using a semi-structured interview guide, and then analyzed using thematic content analysis. 

Competencies of nursing assistants were divided into seven domains: 1) providing care for dependent patients in terms of hygiene and environment, including skills in observation, basic physical assessment, assistance with personal hygiene, and identifying environmental risks to ensure safety, 2) performing non-complex nursing tasks in daily routines, encompassing activities of daily living (ADL) assessment, personal hygiene care, food and medication management, accident prevention, and support for cultural and religious practices in a multicultural setting, 3) preventing complications and monitoring symptoms, notably observing adverse effects of substance use, withdrawal symptoms, early warning signs of aggression, as well as measuring vital signs, and providing basic emergency assistance, 4) documenting symptoms and essential information, including monitoring changes in condition, identifying risk behaviors, supervising medication adherence, and collaborating with nurses in documentation for physician reporting, 5) assisting physicians and nurses in examination and treatment, including patient preparation, specimen collection, acting as language mediators, assessing psychological readiness, applying safe restraint when necessary, communicating with relatives, and managing emergency situations, as well as coordinating with families and supporting family therapy activities, 6) preparing emergency equipment, managing the environment, and assisting in emotional regulation of patients, and 7) supporting rehabilitation according to treatment plans, including leading group activities, promoting physical and psychological recovery, life skills development, vocational therapy, enhancing critical thinking, and advancing competencies through continuing education.

Nursing organizations can use the results from this research to inform workforce development planning and to design targeted training programs to strengthen nurse assistants’ competencies in caring for psychiatric patients and patients with substance abuse in the multicultural context of Southern Thailand.