Patient social functioning in acute mental health inpatient wards: the role of emotional regulation, attachment styles and nurse-patient relationships

Background: Improvement in social functioning is an important aspect of recovery from severe mental health problems. Nurses on acute mental health wards play an important role in facilitating this recovery. It is therefore important to explore potential predictors of social functioning and the quality of nurse-patient relationships. Objectives: To explore associations between patient social functioning, nurse-patient therapeutic alliance, emotional regulation, attachment style and nurse distress in acute mental health settings. Design: Questionnaire-based, cross-sectional study with correlational and regression analyses. Settings: Acute mental health inpatient wards across four NHS trusts in the North-West of England. Participants: Fifty nurse-patient dyads. Methods: Patients and nurses completed questionnaires regarding demographic information, emotional regulation, attachment style and alliance. Nurses also rated patient social functioning and their own distress.Results: Patient anxious attachment style was associated with difficulties in regulating emotions. Patient emotion regulation, patient insecure attachment and the patient-rated alliance predicted nurse-rated patient social functioning. Nurse emotion regulation, nurse insecure attachment style and nurse-rated alliance did not significantly predict nurse-rated patient social functioning and correlations were non-significant. Nurse distress was associated with nurse emotion regulation, nurse anxious attachment and nurse-rated alliance. These factors significantly predicted nurse distress. Conclusions: Patient social functioning is predicted by emotion regulation, attachment and alliance. Similarly, nurse distress is predicted by nurse emotion regulation, attachment style and alliance. Interventions targeting emotion regulation or attachment informed wards would be beneficial.