When Care Becomes Digital: Shared Experiences in Psychiatric Nursing-A Phenomenological Study

Abstract

Aim This qualitative study explores how digitalisation primarily through electronic health records and digital documentation systems is experienced by psychiatric nurses and patients within a state hospital in eastern Turkey, with particular attention to its perceived influence on professional identity, the therapeutic relationship, and ethical responsibilities. References to artificial intelligence in this paper reflect participants' anticipatory perceptions rather than documented routine AI use in this setting.Methods Using a qualitative, phenomenologically informed approach, data were collected from 16 psychiatric nurses and 14 patients in a Turkish state hospital through semi-structured interviews and analysed using Colaizzi's seven-step descriptive phenomenological method.Findings The findings suggest separate themes for nurses and patients, followed by three integrated themes reflecting their shared experiences: 'Identity Under the Pressure of Digitalisation: The Silent Rewriting of the Professional Role,' 'The Fragility of the Therapeutic Relationship in Screen-Mediated Care,' and 'The Digital Trust Paradox: Between Privacy, Surveillance, and Responsibility.' Participants described that digitalisation was associated with increased efficiency and professional visibility, while also being experienced as contributing to more structured and technically oriented care practices, perceived reductions in empathic engagement, and concerns related to trust and privacy.Conclusion Overall, the findings suggest that digitalisation in psychiatric nursing is experienced as extending beyond technical efficiency to include changes in how professional identity and therapeutic relationships are perceived. Participants described that digital practices may be experienced as introducing more technical and screen-mediated elements into care, which may be perceived as limiting empathic engagement and aspects of the therapeutic relationship. In addition, participants reported concerns related to digital trust, including issues of privacy, surveillance, and responsibility. Specifically, participants described a perceived shift from relational to technical care, a 'digital trust paradox' in which surveillance and accountability coexist with distrust, and a concern that screen-mediated work distances nurses from the humanistic core of their role. These findings highlight the importance of developing context-sensitive and ethically informed approaches to the use of digital systems, rather than assuming widespread or routine use of artificial intelligence in clinical practice.