Masters - Research Participant Five

The fifth interview was the only one I carried out where the nurse and the patient were not from the mental health field but rather both were from the general nursing field. Although this was not something directly commented on by the interviewee. The interviewee, who was working as a community nurse at the time, explained that she had built a rapport with the patient over a prolonged period and that she had previous knowledge of the patient and her complicated and substantial physical health difficulties. The nurse also reported knowing the patient was married and had two grown up sons. The nurse called round one day and noticed a change in her patient’s mood and presentation, citing that the patient was reporting a migraine. One the next visit the nurse recalled that the patient reported further symptoms to her, which included severe stomach cramps, constipation, backache, the headaches, fatigue, nausea and that she often felt bloated despite not eating much. Whilst physical symptoms where present there was as yet no assumption or belief in a pregnancy as the patient was ‘putting it down to flu’. The belief in the pregnancy only came about by chance when the doctor, who the interviewee stated was ‘finding it hard to pin-point what was wrong’ got the patient to do a pregnancy test simply to rule the option out. However, the nurse explains that the pregnancy test actually came back positive and the patient was ‘shocked by this’. It was the result of this pregnancy test that the interviewee states sparked the pseudocyesis when the patient became increasingly convinced of her having conceived and began thinking ‘maybe she was’. A second pregnancy test was done which returned a negative reading. This clash in the two test results the nurse revealed caused internal conflict within the family with the patient believing that she was pregnant and her husband believing that the first pregnancy test had simply been a dud and given a false reading. The patient then underwent further tests to establish whether she was or was not pregnant but these proved to be negative in their results. The nurse explains how she then saw her patient enter a period of denial regarding this news and pointed out the ‘pregnancy test discrepancy’. The interviewee goes on to state that the doctor eventually diagnosed the patient as having irritable bowel syndrome in tandem with her other physical difficulties (Seffah 2004) and presents this as being the reason behind the presenting physical symptoms. The patient accepts this and the nurse says that the patient felt ‘embarrassed and I believe that she was disappointed too’. She concludes by revealing that the patient since talked little of the pseudocyesis and on the occasion she did describes her actions and beliefs at the time as being ‘foolish’. This nurse’s lived experience was of noticing a change in her patient’s presentation after a dud pregnancy test gave a false reading. The nurse describes witnessing a usually rational patient become more entwined in her false conviction. The nurse is sensitive towards her patient and is able to sense her feelings in the aftermath of the pseudocyesis reported that she was ‘embarassed’ and ‘scalds herself’ for what happened.