Reflection of Clinical Practice Experience in Psychiatric Nursing on Students' Perceptions of Psychiatric Patients: A Metaphor Study

Abstract

Objective: This study aimed to explore the changes in nursing students' perceptions of psychiatric patients following psychiatric nursing clinical practice by using metaphor analysis. Methods: This qualitative study employed metaphor analysis. The sample comprised 135 final- year nursing students in Türkiye who had successfully completed psychiatric nursing clinical practice during the 2024–2025 academic year, selected through criterion sampling. Inclusion criteria were being a final-year nursing student, completion of psychiatric nursing clinical practice, and voluntary participation. Data were collected using a semi-structured interview form that included metaphor-based prompts addressing students' perceptions of psychiatric patients before and after clinical practice. The data were analyzed using content analysis and reported in accordance with the COREQ checklist. Results: A total of 135 valid metaphor expressions were analyzed. Two main themes were identified: perceptions of psychiatric patients before clinical practice and perceptions and experiences developed after clinical practice. Prior to clinical practice, students' metaphors reflected fear and insecurity (54.8%), social impact and stigmatization (30.4%), and lack of knowledge and prejudice (14.8%). After clinical practice, students' metaphors shifted toward empathy and the breaking of prejudices (41.5%), therapeutic communication and a humanistic approach (32.6%), and professional awareness regarding the nature of psychiatric illness (25.9%) indicating a clear positive transformation in perceptions. Conclusions: The findings demonstrate that psychiatric nursing clinical practice plays a critical role in transforming nursing students' negative and stigmatizing perceptions of psychiatric patients into more empathetic, humanistic, and professional perspectives. By revealing this perceptual transformation through metaphor analysis, the study contributes to the literature by highlighting the educational value of clinical practice in reducing stigma and fostering professional awareness in psychiatric nursing education.