Nurse-Provided Foot Care for Populations with Severe Mental Illness: A Phenomenological and Swanson’s Theory of Caring Approach

Abstract

Foot care is an essential element of health care for populations with, or at high risk for chronic diseases and foot abnormalities. However, nursing research regarding foot care specifically for patients with severe mental illness (a category which includes bipolar disorder, schizophrenia, and schizoaffective disorder) is sparse. This mixed methodology phenomenological study seeks to provide a further understanding of how nurse-provided foot care and its implicit “caring” ethos impact this patient population, and what might this imply about creating models and educational protocols for the delivery of future evidence-based care. Methodology: Participants at a low-barrier day center for populations who self-identified as female, unhoused, and diagnosed with severe mental illness were treated with nurse-provided foot care. Data was collected from a five-question semi-structured interview, focused on the participant’s experience of foot care and then thematically coded. Results: Six participants fulfilled eligibility requirements, provided informed consent, and completed the semi-structured interviews. Five main themes emerged from data analysis: 1) apprehension to enjoyment, 2) self-criticism, 3) importance of hygiene, 4) inclusion of anecdotal experience, and 5) attitude of the practitioner. Conclusion: This research project called attention to the need for increased access and provision of hygiene supplies and the relevance of incorporating relationship-based therapeutic foot care. The process of addressing these issues will require focusing on these needs in the development of models for hygiene access provision as well as incorporating the importance of a Swanson’s Theory of Caring derived education protocol