'The Bird Fights Its Way Out of the Egg': A Phenomenological Study of Nurses' Lived Experiences of Self-Care in South Korea's Closed Psychiatric Wards

“小鸟奋力破壳而出”:韩国封闭式精神病房护士自我护理生活体验的现象学研究

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Abstract

Background/Objectives: Nurses working in closed psychiatric wards experience substantial psychosocial and spiritual burdens, emotional strain, and ethical tension due to continuous exposure to patients in crisis. As formal caregivers, nurses' health and multidimensional well-being are essential for sustaining compassionate, dignity-preserving practice. However, the lived meaning of self-care within highly restrictive psychiatric environments remains insufficiently understood. This study explores how psychiatric nurses in South Korea experience and interpret self-care. Methods: A qualitative phenomenological design was used. Eight psychiatric nurses with more than three years of experience in closed psychiatric wards participated in in-depth, face-to-face interviews conducted between August 2018 and January 2019. Data were analysed using Colaizzi's method to identify and synthesise essential themes. Results: Five categories captured the essence of nurses' self-care experiences: (1) struggling to establish therapeutic roles as a psychiatric nurse; (2) conflating professional identity with ideals of good nursing; (3) recognising a gradual loss of motivation and hope to continue psychiatric nursing; (4) acknowledging the need to care for oneself and refocus on inner vitality; and (5) engaging in self-care through interactions with patients. Self-care was understood as a reflective, relational, and transformative process rather than as a set of stress-relief activities. Conclusions: Psychiatric nurses perceived self-care as an existential journey involving vulnerability, self-reflection, and renewal, which fostered both personal and professional growth. By framing self-care as an ethically grounded, relational practice that sustains therapeutic presence and safeguards moral and professional integrity, this study extends existing self-care literature beyond behavioural strategies.

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