Perspectives of Nurses and Adolescents About Pro Re Nata Treatment in Adolescent Inpatient Psychiatric Units: A Qualitative Study.
Augustin Behaghel, Elise Jean, Hélène Cipel and 4 others
PMID 40637296WHAT IT FOUND
Adolescents and nurses described PRN medication as a tool for autonomy and dialogue rather than just symptom control.
Nurses used PRN requests to gauge distress levels and build trust, while adolescents viewed the transition to PRN as a step toward discharge and self-management.
Key findings
01Nurses viewed PRN administration as a way to assess the adolescent's level of suffering, using the frequency of requests as an indicator of anxiety intensity.
02Adolescents linked the transition from scheduled medication to PRN with upcoming discharge, seeing it as an opportunity to make autonomous decisions about their care.
03The therapeutic relationship was central to PRN use; nurses often prioritized dialogue and trust, sometimes delaying conversation until the medication took effect to de-escalate intense distress.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in two French units where the term for PRN ('traitement si besoin') may influence how patients and staff perceive the intervention's purpose. The sample excluded adolescents with ADHD, conduct disorders, or autism spectrum disorders, who may have different experiences with agitation and coercion. The study did not include current or former patient representatives in the research team, which might have limited the participatory aspect of the analysis. Findings are based on self-reported experiences and cannot establish causal links between PRN use and clinical outcomes.
The easy way to misread this
Do not interpret the positive descriptions of PRN as evidence that medication is the most effective way to manage agitation. The study reports perceptions, not outcomes; nurses and adolescents valued the relational context of the administration, which may have contributed to the perceived benefit more than the drug itself.