Status of the psychological contract between psychiatric nurses and head nurses from a dual perspective: A qualitative study

BACKGROUND: Existing research on psychological contracts predominantly focuses on quantitative studies of organizational management, employee behavior, and leadership styles, with limited exploration of specific occupational groups in specialized settings. OBJECTIVE: To understand the current situation of the implementation of the psychological contract between psychiatric nurses and head nurses from a dual perspective, and to provide a basis for promoting the collaboration of nursing teams, improving the quality of nursing, and improving the management of psychiatric nursing. METHODS: A descriptive qualitative research method was used to conduct semi-structured interviews with 8 psychiatric head nurses and 13 psychiatric nurses from a tertiary-level A psychiatric hospital in Henan Province, China. Braun and Clarke's six-step thematic analysis method was used to distill themes. RESULTS: The study distilled the theme from two dimensions, the psychiatric nurses' perspective psychological contract focuses on subjective commitment and perceived fulfillment of organizational responsibilities, and the psychiatric head nurses' perspective psychological contract emphasizes self-empowerment and psychological contract supply-side management. CONCLUSIONS: The psychological contract of psychiatric nursing teams is not only influenced by personal effort and responsibility, but also by the empowerment of hospital management and organizational culture. It is suggested that the interaction mode should be optimized through management measures such as fairness of work arrangement, empathetic leadership, attention to nurses' invisible contributions, and two-way feedback of the system, so as to improve nurses' sense of professional safety and team cohesion, and then improve work efficiency and nursing quality.