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Li Y, Gui J, Wang Y, Zhang X, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Zhang L. A study on the "community-hospital-community" model of community nursing practice teaching for undergraduate nursing students. BMC Nurs 2023; 22:385. [PMID: 37845708 PMCID: PMC10580528 DOI: 10.1186/s12912-023-01550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To improve the quality of community nursing teaching practice and cultivate undergraduate nursing students who meet the quality accreditation standards of our nursing profession, and to explore the establishment of an undergraduate nurse practice model. METHODS Using the methods of literature review, survey, expert consultation, and discussion, we established the steps and contents of community practice teaching for undergraduate nursing students, and implemented them for the students of Grades 2014, 2015, and 2016, and evaluated the "community-hospital-community" practice model through various forms, such as student self-evaluation, faculty evaluation, exit examination, and evaluation by certified experts. RESULT A three-stage community nursing practice model of "community-hospital-community" was established for undergraduate nursing students. After three stages of practice, nursing undergraduates successfully passed the practical assessments and achieved excellent grades in each stage that met the requirements of the training program. In the first stage (community probation), community probation emphasizes a fundamental understanding of the community, using free clinics, health education, and home visits as entry points to effectively cultivate students' job competence and proficiency in nursing operations and nurse-patient communication skills. In the second stage (internship in the hospital), through nursing internships in various systems, students are trained to integrate theoretical knowledge with practical skills and consolidate their understanding of fundamental knowledge, theory, and techniques. They are capable of preventing, diagnosing, intervening, and providing health education for common, frequent, urgent and critical complications in various clinical systems. They can formulate nursing plans and implement whole-person care. In the third stage (returning to the community for internship), students can master basic skills such as nursing operations and patient communication skills, and then they can enter the community internship. CONCLUSION The community nursing practice model of "community- hospital- community" for undergraduate nursing students can systematically train undergraduate nursing students' ability to work in the community.
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Affiliation(s)
- Yuqing Li
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ying Wang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Haiyang Liu
- Student health center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, P.R. China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China.
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Sorgi-Wilson KM, McCloskey MS. Emotion regulation strategies among individuals with borderline personality disorder relative to other groups: A review. Clin Psychol Psychother 2022; 29:1655-1678. [PMID: 35366040 DOI: 10.1002/cpp.2738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/28/2022] [Accepted: 03/29/2022] [Indexed: 11/11/2022]
Abstract
Borderline personality disorder (BPD) is associated with difficulties in emotion regulation (ER) abilities. Investigations of ER strategies in BPD have been less robust. This systematic review identified 55 studies comparing ER strategy use between individuals diagnosed with BPD versus psychiatric and non-psychiatric comparison groups. Individuals with BPD reported more frequent maladaptive and less frequent adaptive ER strategy use than non-psychiatric controls. Results were less consistent relative to psychiatric comparison groups, though individuals with BPD reported greater self-criticism and avoidance. Groups responded comparably to instructed use of adaptive (but not maladaptive) ER strategies. This body of research would benefit from further examination of the roles of psychiatric comorbidity and problematic behaviours in the relationship between BPD and ER strategies.
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Affiliation(s)
- Kristen M Sorgi-Wilson
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Michael S McCloskey
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
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Massó Rodriguez A, Hogg B, Gardoki-Souto I, Valiente-Gómez A, Trabsa A, Mosquera D, García-Estela A, Colom F, Pérez V, Padberg F, Moreno-Alcázar A, Amann BL. Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies. Front Psychiatry 2021; 12:681876. [PMID: 34177664 PMCID: PMC8220090 DOI: 10.3389/fpsyt.2021.681876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/14/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) have clinically been evolving as separate disorders, though there is still debate on the nosological valence of both conditions, their interaction in terms of co-morbidity or disorder spectrum and their distinct pathophysiology. Objective: The objective of this review is to summarize evidence regarding clinical features, neuropsychological performance and neuroimaging findings from cross-diagnostic studies comparing BD and BPD, to further caracterize their complex interplay. Methods: Using PubMed, PsycINFO and TripDataBase, we conducted a systematic literature search based on PRISMA guidelines of studies published from January 1980 to September 2019 which directly compared BD and BPD. Results: A total of 28 studies comparing BD and BPD were included: 19 compared clinical features, 6 neuropsychological performance and three neuroimaging abnormalities. Depressive symptoms have an earlier onset in BPD than BD. BD patients present more mixed or manic symptoms, with BD-I differing from BPD in manic phases. BPD patients show more negative attitudes toward others and self, more conflictive interpersonal relationships, and more maladaptive regulation strategies in affective instability with separate pathways. Impulsivity seems more a trait in BPD rather than a state as in BD. Otherwise, BD and BPD overlap in depressive and anxious symptoms, dysphoria, various abnormal temperamental traits, suicidal ideation, and childhood trauma. Both disorders differ and share deficits in neuropsychological and neuroimaging findings. Conclusion: Clinical data provide evidence of overlapping features in both disorders, with most of those shared symptoms being more persistent and intense in BPD. Thus, categorical classifications should be compared to dimensional approaches in transdiagnostic studies investigating BPD features in BD regarding their respective explanatory power for individual trajectories. Systematic Review Registration: The search strategy was pre-registered in PROSPERO: CRD42018100268.
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Affiliation(s)
- Anna Massó Rodriguez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centro Salud Mental Infanto-Juvenil, Parc de Salut Mar, Barcelona, Spain
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Valiente-Gómez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Amira Trabsa
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Dolores Mosquera
- Instituto de Investigación y Tratamiento del Trauma y los Trastornos de la Personalidad (INTRA-TP) Center, A Coruña, Spain
| | - Aitana García-Estela
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Francesc Colom
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Departament of Basic, Evolutive and Education Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Pérez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Benedikt Lorenz Amann
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- *Correspondence: Benedikt Lorenz Amann
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Grant M, Salsman NL, Berking M. The assessment of successful emotion regulation skills use: Development and validation of an English version of the Emotion Regulation Skills Questionnaire. PLoS One 2018; 13:e0205095. [PMID: 30281666 PMCID: PMC6169969 DOI: 10.1371/journal.pone.0205095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 09/19/2018] [Indexed: 12/22/2022] Open
Abstract
Emotion regulation has become an important topic in mental health and psychotherapy research. Skills supposingly relevant for adaptive responses towards emotions include the abilities to be consciously aware of emotions, identify and correctly label emotions, understand what has caused and maintains one’s present emotions, modify the intensity or duration of one's emotions, accept and tolerate undesired emotions, confront situations likely to cue negative emotions, and provide effective self-support when working to cope with challenging emotions. To economically assess these abilities, a self-report measure has been developed in German and validated in various studies. To facilitate the use of the measure in English speaking countries, we have developed and validated an English version of the Emotion Regulation Skills Questionnaire (ERSQ) in a student sample (n = 263) and a sample of individual clinical sample (n = 35). Findings from this study provide significant evidence for the reliability and validity of the ERSQ. Thus, the measure can be used to assess a broad range of important emotion regulation skills in an economic way.
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Affiliation(s)
- Michaela Grant
- Department of Clinical Psychology and Psychotherapy, University of Mainz, Mainz, Rhineland Palatinate, Germany
- * E-mail:
| | - Nicholas L. Salsman
- Department of Clinical Psychology, Xavier University, Cincinnati, Ohio, United States of America
| | - Matthias Berking
- Department of Clinical Psychology und Psychotherapy, University of Erlangen-Nueremberg, Erlangen, Bavaria, Germany
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Starrs CJ, Perry JC. Coping Action Patterns as Mechanisms of Change Across Psychotherapies: Three Case Examples of Personality Disorders With Recurrent Major Depression. J Pers Disord 2018; 32:58-74. [PMID: 29388894 DOI: 10.1521/pedi.2018.32.supp.58] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Maladaptive coping has been shown to be related to increased symptoms of distress and lower levels of well-being, whereas the use of adaptive coping has been shown to diminish distress and improve functioning. This suggests that change in coping may constitute a significant mechanism of change in psychotherapy. Utilizing a novel observer-rating method for assessing coping, the current report examined changes in overall coping functioning (OCF) in three participants with diverse personality disorders who were undergoing two different types of psychotherapy (cognitive-behavioral therapy and dynamic therapy) for recurrent major depression. Results showed that overall coping functioning improved in two cases and remained stable in a third. Preliminary findings, based on a detailed examination of changes in specific coping patterns, suggest that improvement may differ according to severity of personality pathology. As hypothesized, coping improved in both types of psychotherapy. Thus, overall results suggest that coping may constitute an important general mechanism of change.
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Affiliation(s)
| | - J Christopher Perry
- Department of Psychiatry, McGill University at the Jewish General Hospital, Institute of Community and Family Psychiatry, Montréal, Québec, Canada
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Kramer U. The Role of Coping Change in Borderline Personality Disorder: A Process-Outcome Analysis on Dialectical-Behaviour Skills Training. Clin Psychol Psychother 2016; 24:302-311. [PMID: 27098296 DOI: 10.1002/cpp.2017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/11/2016] [Accepted: 03/22/2016] [Indexed: 11/06/2022]
Abstract
Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Skills training concepts based on dialectical-behaviour therapy (DBT) are common and effective treatment options for specifically addressing lacking skills in emotion regulation. However, so far it is unclear which aspects of coping change over the course of DBT skills training and if these coping strategies predict symptom change. The present process-outcome analysis, based on a randomized controlled study, aims at investigating these questions, by referring to a general conception of coping and by using an observer-rated approach to assess coping strategies directly in the therapy sessions. In total, n = 31 patients with BPD underwent two individual clinical interview assessments (pre- and post-study intervention; half of the patients underwent DBT skills training, half were in a wait-list control). All individual assessment sessions were transcribed and analysed using the Coping Action Pattern Rating Scale. Outcome was assessed pre- and post-intervention using the Outcome Questionnaire-45.2 and the Borderline Symptom List 23. The results showed increase in overall coping functioning in patients who underwent the DBT skills training, compared with the controls, and specific increases in relatedness coping where the stress is appraised as challenge, along with specific decreases in autonomy coping where the stress is appraised as threat. These changes predicted changes in general distress and borderline symptomatology. The results are interpreted within a general framework aiming at understanding the psychological effects of treatments for BPD, in particular effects related to coping. Effective emotion regulation strategies may therefore be important candidates as potential change mechanisms in treatments for BPD. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE It seems important for clinicians to assess the quality of coping strategies as they occur within the session facing a patient with borderline personality disorder. Clinicians may foster the emergence of support-seeking and self-reliance coping strategies in order to increase the effectiveness of therapy. Clinicians may monitor closely the patient's use of ineffective emotion regulation strategies, in particular opposition and submission, with the aim of reducing them early in therapy.
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Affiliation(s)
- Ueli Kramer
- Institute of Psychotherapy, Department of Psychiatry-CHUV, University of Lausanne, Lausanne, Switzerland.,General Psychiatry Service, Department of Psychiatry-CHUV, University of Lausanne, Lausanne, Switzerland.,Department of Psychology, University of Windsor, Windsor, Canada
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Kramer U, Pascual-Leone A, Berthoud L, de Roten Y, Marquet P, Kolly S, Despland JN, Page D. Assertive Anger Mediates Effects of Dialectical Behaviour-informed Skills Training for Borderline Personality Disorder: A Randomized Controlled Trial. Clin Psychol Psychother 2015; 23:189-202. [PMID: 25864773 DOI: 10.1002/cpp.1956] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/10/2015] [Accepted: 03/14/2015] [Indexed: 12/14/2022]
Abstract
UNLABELLED Dialectical behaviour therapy (DBT)-informed skills training for borderline personality disorder (BPD) aims at the development of specific emotion regulation skills in patients, particularly with regard to the regulation of problematic anger. While the effects of dialectical behaviour skills training have been shown, their processes of change are rarely examined. Neacsiu, Rizvi and Linehan (2010) found that patient's self-reported use of emotion regulation skills was a mediator of therapeutic change in these treatments; however, they found no effect for problematic anger. From an integrative perspective on anger (Pascual-Leone & Greenberg, 2007; Pascual-Leone & Paivio, 2013), there are several forms of anger, varying in their degree of therapeutic productivity. The present add-on randomized controlled trial included n = 41 patients with BPD (n = 21 DBT-informed skills training versus n = 20 treatment as usual). The first study examined the outcome of the DBT-informed skills training encompassing basic components of training in mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Results showed that symptom reduction was significantly greater in the DBT-informed skills training, compared with the treatment as usual. The second study used process assessment, for which all patient completers underwent a 50-min-long psychological interview both early and late in treatment, which was rated using the Classification of Affective Meaning States. DBT-informed skills training produced increased levels of primary 'assertive' anger, as compared with the treatment as usual, whereas no effect was found for 'rejecting' secondary anger. Most importantly, we showed that changes in assertive anger mediated the reported symptom reduction, in particular in patient's social roles. We discuss these results in the context of underlying mechanisms of change in DBT skills group treatments, in particular towards developing more productive forms of anger in this patient population. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE A 20-session dialectical behaviour therapy (DBT)-informed skills training is a promising adjunct intervention for patients with borderline personality disorder, in particular for reducing problems related to social role. Increases in assertive anger mediate the effects of DBT-informed skills training, whereas rejecting anger remains unchanged over the course of treatment. Short-term objectives for intervention might involve the specific increase of assertive anger in BPD, by using DBT-informed skills training; long-term objectives for intervention might involve a specific decrease of rejecting anger in BPD.
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Affiliation(s)
- Ueli Kramer
- Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
- General Psychiatry Service, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | | | - Laurent Berthoud
- Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Yves de Roten
- Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Pierre Marquet
- General Psychiatry Service, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Stéphane Kolly
- General Psychiatry Service, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Jean-Nicolas Despland
- Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Dominique Page
- Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
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