Sci Rep. 2025 Nov 18;15(1):40603. doi: 10.1038/s41598-025-24364-2.
ABSTRACT
The DREAM guideline (Dedication, Respect through relationship, Environment, Art of nursing, and Motivation) was initially developed from a study exploring nurses’ perceptions regarding presence in a rural area of the North West Province, South Africa. To further examine its applicability, it was necessary to validate the guideline in other nursing contexts, particularly in mental health nursing. Such a context is public psychiatric hospitals where adolescents are admitted with conditions like depression, anxiety, eating disorders, and behaviour disorders, and provided mainly with custodial care, including medication administration and supervision. Implementing a presence-based approach in such settings could be beneficial. To validate the DREAM guideline, this study aimed to explore and describe the perceptions of mental health nurses regarding the DREAM presence practice guideline in providing care to adolescents with mental illnesses. The study was conducted in two major psychiatric hospitals in the North West Province, South Africa. The authors utilized a qualitative research approach with an exploratory-descriptive, contextual design. Participants were purposefully selected based on their experience in direct nursing care of adolescents with mental illnesses and their attendance at a DREAM guideline workshop. Data collection involved focus group discussions, with each group consisting of four or six participants, depending on the setting. Thematic analysis, incorporating deductive and inductive strategies, were used for data analysis. Four themes emerged: (1) Holistic and compassionate care: perceptions of mental health nurses providing care to adolescents with mental illnesses, (2) Empowering mental health nurses through the DREAM guideline: perspectives on providing care to adolescents with mental illnesses, (3) Challenges and barriers in implementing the DREAM guideline for mental health nurses and (4) Improving the DREAM practice in caring for adolescents with mental illnesses. This study’s findings offer valuable insights into how the DREAM guideline can be used as a presence practice in mental health nursing to promote better patient outcomes and enhance nurses’ professional experiences. These contributions are poised to drive improvements in mental healthcare delivery, patient satisfaction, and the overall well-being of healthcare professionals in the field.
PMID:41254035 | DOI:10.1038/s41598-025-24364-2
