Care needs of adult patients in psychiatric inpatient settings based on the fundamentals of care framework: An integrative review

Abstract

Psychiatric inpatient units, designed for short stays, should support advanced person-centered care for individuals with acute mental disorders. The threshold for psychiatric hospital admission has risen, and patients present with increasingly complex care needs. Accurately identifying these needs is critical for individualized care planning and determining appropriate care levels. However, research on adult care needs in psychiatric inpatient settings remains limited. This integrative review aimed to identify, describe, and synthesize the care needs of adult psychiatric inpatients reported in the literature, using the Fundamentals of Care Framework. A systematic search of three electronic databases was conducted in January 2025. Methodological quality was assessed with the revised Mixed Methods Appraisal Tool (MMAT), and findings were narratively synthesized according to the review's objectives. Thirty-seven studies published between 1977 and 2024 were included. The core care needs centered on safety, emotional well-being, and being involved and informed. Notably, nurses and patients expressed differing views on psychosocial needs. Despite heterogeneity in existing research, findings suggest promising benefits for nursing practice. The divergence between nurses' and patients' perspectives underscores the need for holistic, collaborative care planning. Furthermore, the strong emphasis on safety among nursing staff reflects a risk-oriented culture that may overshadow other essential aspects of care. Further research is warranted to deepen understanding and inform evidence-based practices for adult psychiatric inpatients.