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Watkin F, Scott H, Richards R. The role of psychological formulation in inpatient settings in supporting staff empathy and therapeutic optimism for adults diagnosed with borderline personality disorder: A pre- and post-vignette study. J Psychiatr Ment Health Nurs 2024. [PMID: 39011588 DOI: 10.1111/jpm.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 06/19/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Psychological formulation brings together a service user story and expertise, with psychological knowledge, research, and practitioners clinical experience to make sense of a service users' presentation (thinking about their difficulties but also strengths). Evidence into the effectiveness of formulation is largely anecdotal, qualitative, or small scale. Although this is very valuable research, there is not a lot of research which quantitatively evidences the role of formulation for service users or services. Quantitative evidence that does exist is also conflicting. Considering how widely psychological formulation is used, and the governing guidelines that recognize this as a core competency for psychological practitioners, it is important to continue to add to the evidence base. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Psychological formulation can increase staff empathy and hope. This could help service users to feel more understood and hopeful. Formulation; however, did not impact feelings of personal distress in staff. This research may suggest a need for the two distinct processes (i.e. team formulation and reflective practice) to support all components of empathy within inpatient services. Psychological formulation could support the provision of psychologically informed care within inpatient services, of which promotes effective care delivery. ABSTRACT OBJECTIVES: National Health Service (NHS) values, such as empathy and therapeutic optimism, are integral when supporting service users with complex mental health presentations. There is some evidence to suggest that psychological formulation can increase empathy and optimism in healthcare professionals. This study, therefore, aimed to investigate whether a psychological formulation of a hypothetical service user with a complex presentation, typically labelled with a diagnosis of borderline personality disorder (BPD), increased empathy and therapeutic optimism in professionals working in mental health inpatient services. METHOD Sixty-six mental health professionals working in NHS inpatient services took part in a pre- and post-vignette study. Participants were asked to read a case vignette about a hypothetical service user, with a diagnostic label of BPD, and complete questionnaires capturing levels of empathy and therapeutic optimism. Participants were then randomized into two conditions and either asked to read the same information again (control condition) or read a psychological formulation based on the same hypothetical service user (intervention condition). The findings were analysed using a series of ANCOVAs/ANCOHETs. RESULTS Two constructs of empathy (i.e. perspective taking and empathic concern), and therapeutic optimism significantly increased following exposure to the psychological formulation when compared to the control group condition. CONCLUSION This study warrants further replication. These initial findings; however, indicate that psychological formulation can significantly increase the ability to perspective take, display empathic concern, and hold therapeutic optimism towards service users with a presentation associated with a diagnosis of BPD.
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Affiliation(s)
| | - Helen Scott
- North Staffordshire Combined Healthcare Trust, Stoke-on-Trent, UK
| | - Ruth Richards
- North Staffordshire Combined Healthcare Trust, Stoke-on-Trent, UK
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Seal EL, Kokanović R, Flore J, Borovica T, Broadbear JH, McCutcheon L, Lawn S. Talking about borderline personality disorder, shaping care: The multiple doings of narratives. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38838130 DOI: 10.1111/1467-9566.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
This article focuses on the narratives that circulate about borderline personality disorder (BPD) in health-care settings in Australia and the effects such narratives can have on how people practice and seek out care. People with a BPD diagnosis frequently access health-care services, often encountering stigma and discrimination. Drawing on narrative theory, we critically unpack the circulation and capacities of BPD narratives and the ways they can often contribute to poor and troubling experiences. This article is based on qualitative interviews with people living with a BPD diagnosis, as well as health practitioners who work with people with a BPD diagnosis. Our findings identified insidious and powerful BPD narratives that circulate in health-care settings, particularly in short-term, acute, or non-specialist contexts, such as emergency departments and in-patient units. These narratives influenced the ways that participants both practiced and sought out care. To improve health service quality for people with a BPD diagnosis, or those experiencing mental distress, it is important to challenge the sociocultural-political norms and relations that can influence approaches to care and practice. Disrupting and reframing negative BPD narratives and raising awareness about the impact of stories that are told about BPD have the potential to generate social change.
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Affiliation(s)
- Emma-Louise Seal
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Renata Kokanović
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Jacinthe Flore
- School of Historical and Philosophical Studies, University of Melbourne, Melbourne, Victoria, Australia
| | - Tamara Borovica
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Jillian H Broadbear
- Spectrum Personality Disorder and Complex Trauma Service, Eastern Health, Richmond, Victoria, Australia
- Eastern Health Clinical School, Monash University, Clayton, Victoria, Australia
- Personality Disorder and Complex Trauma Research and Innovation Centre, Richmond, Victoria, Australia
| | | | - Sharon Lawn
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Lived Experience Australia Ltd, South Australia, South Australia, Australia
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3
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Zhu Z, Liu S, Zhang R. Examining the Persuasive Effects of Health Communication in Short Videos: Systematic Review. J Med Internet Res 2023; 25:e48508. [PMID: 37831488 PMCID: PMC10612001 DOI: 10.2196/48508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The ubiquity of short videos has demonstrated vast potential for health communication. An expansion of research has examined the persuasive effect of health communication in short videos, yet a synthesis of the research is lacking. OBJECTIVE This paper aims to provide an overview of the literature by examining the persuasive effect of health communication in short videos, offering guidance for researchers and practitioners. In particular, it seeks to address 4 key research questions: What are the characteristics of short videos, samples, and research designs in short video-based health communication literature? What theories underpin the short video-based health communication literature? What are the persuasive effects of health communication in short videos? and What directions should future research in this area take? METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 10 databases up to March 10, 2023, generated 4118 results. After the full-text screening, 18 articles met the eligibility criteria. RESULTS The current research lacks a uniform definition of short videos, demonstrates sample biases in location and education, and adopts limited methodologies. Most studies in this synthesis are theoretically grounded or use theoretical concepts, which are predominantly well examined in persuasion research. Moreover, relevant topics and suitable themes are effective in persuasive health communication outcomes, whereas the impact of diverse narrative techniques remains ambiguous. CONCLUSIONS We recommend that future research extends the definition of short videos beyond time constraints and explores non-Western and less-educated populations. In addition, researchers should consider diverse methods to provide a more comprehensive examination and investigate the impact of audience targeting and narrative techniques in short video health communication. Finally, investigating how the unique aspects of short videos interact with or challenge traditional persuasion theories is essential.
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Affiliation(s)
- Zicheng Zhu
- Department of Communications and New Media, Faculty of Arts & Social Sciences, National University of Singapore, Singapore, Singapore
| | - Shiyu Liu
- Global Health Institute, Xi'an Jiaotong University, Xian, China
| | - Renwen Zhang
- Department of Communications and New Media, Faculty of Arts & Social Sciences, National University of Singapore, Singapore, Singapore
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4
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Klein P, Fairweather AK, Lawn S. Structural stigma and its impact on healthcare for borderline personality disorder: a scoping review. Int J Ment Health Syst 2022; 16:48. [PMID: 36175958 PMCID: PMC9520817 DOI: 10.1186/s13033-022-00558-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners. METHODS A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, and the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data. RESULTS A total of 57 citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in health systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis and BPD-related stigma surrounding health and crisis care services. CONCLUSION Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. It is anticipated that results of this review will inform future research, policy, and practice to address BPD-related stigma in health systems, as well as approaches for improving the delivery of responsive health services and care for consumers with BPD and their carers/families. REVIEW REGISTRATION Open Science Framework ( https://osf.io/bhpg4 ).
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Affiliation(s)
- Pauline Klein
- Discipline of Population Health, College of Medicine and Public Health, Flinders University, Adelaide, SA 5001 Australia
| | - A. Kate Fairweather
- Discipline of Population Health, College of Medicine and Public Health, Flinders University, Adelaide, SA 5001 Australia
| | - Sharon Lawn
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Adelaide, SA 5001 Australia
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5
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Judging Personality Disorder: A Systematic Review of Clinician Attitudes and Responses to Borderline Personality Disorder. J Psychiatr Pract 2022; 28:275-293. [PMID: 35797685 DOI: 10.1097/pra.0000000000000642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been suggested that the diagnosis of borderline personality disorder (BPD) is associated with particularly stigmatizing connotations, particularly among mental health professionals. The goal of this study was to synthesize quantitative studies investigating the attitudes and responses of clinicians to BPD and to appraise the methodological quality of these studies. METHODS A systematic search was carried out using MEDLINE Complete, CINAHL Complete, PsychoINFO, PsychARTICLES, Scopus, Social Sciences Citation Index, and Academic Search Complete. Study quality was rated using an adapted tool. RESULTS This review included 37 papers involving an estimated 8196 participants: 21 cross-sectional survey studies, 5 studies assessing training workshops, 5 studies assessing countertransference, and 6 experimental studies. The methodological quality of the studies was mixed, with many differing measures with questionable validity used. CONCLUSIONS Negative attitudes toward BPD continue to be a problem to differing degrees among clinical staff. Although this issue is most prominent among psychiatric nurses, the results of this review highlight evidence of negative attitudes across all mental health professions as well as potentially in professionals working in physical health settings. Various clinician-level factors may play a role in the development and maintenance of such attitudes. Greater exposure to patients with BPD and attendance at training programs have been found to be associated with improved attitudes. Professionals require regular training concerning BPD that is sufficiently evidence-based.
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Yin M, Li W, Yang Q, Yue Y, Fang X, Yang Z, Wang X, Liu Q, Kong F, Ji C, Lv X, Wang H, Yuan N, Li Z, Zhang C, Li K, Yang Y, Du X. The Mediating Role of Coping Style in the Relationship Between Sleep Quality and Burnout: A Cross-Sectional Study Among Psychiatric Nurses. Front Psychiatry 2022; 13:926040. [PMID: 35815050 PMCID: PMC9260227 DOI: 10.3389/fpsyt.2022.926040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Although sleep quality is clearly associated with job burnout as shown in the existing research, the mechanism underpinning such relationship remains undefined. This work, thus, aimed to assess the current situation of sleep quality and burnout in Chinese psychiatric nurses, and to analyze the relationships between sleep quality, burnout and coping style, in order to provide possible targets to enhance mental health and wellbeing among psychiatric nurses. Method This cross-sectional study was carried out in seven rehabilitation centers located in four different regions of China. The Pittsburgh Sleep Quality Index, the Epworth Sleeping Scale, the Maslach Burnout Inventory General Survey, and the Coping Style Questionnaire were distributed to 853 nurses in various mental hospitals, with a total of 664 participants being recruited in the final research. Results The results of this current study showed a high prevalence of sleep disorders and burnout in Chinese psychiatric nurses. Moreover, emotional exhaustion (r = 0.456), cynicism (r = 0.323) and negative coping style (r = 0.191) in nurses were all positively correlated with total Pittsburgh Sleep Quality Index (PSQI) score, while professional efficacy (r = -0.079) and positive coping style (r = -0.140) were negatively correlated with total PSQI score. More interestingly, of all negative coping strategies, we found that self-blame had the most significant effect (β = 0.156). Conclusions The above results showed that coping style mediates the association of poor sleep quality with job burnout in Chinese psychiatric nurses. This study claimed that there is an urgent need to development the coping skills to sustain a healthy work life for nurses.
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Affiliation(s)
- Ming Yin
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Weiqin Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qun Yang
- Nanchong Psychosomatic Hospital, Nanchong, China
| | - Yan Yue
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiaojia Fang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhong Yang
- The Third People's Hospital of Changshu, Suzhou, China
| | - Xinda Wang
- Taicang Third People's Hospital, Suzhou, China
| | - Qin Liu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Fanzhen Kong
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caifang Ji
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaoli Lv
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Hao Wang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Nian Yuan
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caiyi Zhang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Kan Li
- Jiangxi Mental Hospital, Nanchang, China
| | - Yang Yang
- Mental Hospital of Yunnan Province, Kunming, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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7
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Klein P, Fairweather AK, Lawn S. The impact of educational interventions on modifying health practitioners' attitudes and practice in treating people with borderline personality disorder: an integrative review. Syst Rev 2022; 11:108. [PMID: 35637499 PMCID: PMC9150362 DOI: 10.1186/s13643-022-01960-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/11/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The rising prevalence of Borderline Personality Disorder (BPD) and suicidality represents substantial health burden worldwide. People with BPD experience high rates of crisis presentations and stigma when accessing health services. Educational interventions designed to modify health practitioners' attitudes and practice in treating people with BPD may assist in addressing this stigma. The current review aimed to identify and explore existing educational interventions designed to modify health practitioners' attitudes and practice in BPD; and determine what impact educational interventions have on improving health practitioners' responses towards people with BPD. METHODS A comprehensive search of the literature was undertaken in MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 2022). Secondary sources of literature included grey literature searches and handsearching the references of included studies as part of the comprehensive search strategy. The eligibility criteria included peer-reviewed empirical studies examining BPD-related educational interventions aimed at modifying health practitioners' attitudes and practice in treating people with BPD. Quality appraisal of the included studies were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18) or the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool. Thematic Analysis informed data extraction, analysis, interpretation, and narrative synthesis of the data. RESULTS A total of nine papers containing 991 participants across a diverse range of studies including, quantitative, qualitative, mixed methods, and a systematic review were included in this integrative review. Several BPD-related educational interventions designed to modify health practitioners' attitudes and practice in BPD exist. Findings suggest that training health practitioners in BPD-related educational interventions can enhance positive attitudes and change practice towards people with BPD; however, more high-quality studies are needed to confirm these conclusions. CONCLUSIONS This review collated and summarized findings from studies examining the impact of BPD-related educational interventions on changing health practitioners' attitudes and practice in treating this population. Results from this review may help inform future research, policy, and practice in stigma-reduction strategies which would improve the delivery of responsive health services and care for people with BPD. SYSTEMATIC REVIEW REGISTRATION Open Science Framework ( https://osf.io/7p6ez/ ).
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Affiliation(s)
- Pauline Klein
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5001, Australia.
| | - A Kate Fairweather
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5001, Australia
| | - Sharon Lawn
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5001, Australia
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Romeu-Labayen M, Tort-Nasarre G, Rigol Cuadra MA, Giralt Palou R, Galbany-Estragués P. The attitudes of mental health nurses that support a positive therapeutic relationship: The perspective of people diagnosed with BPD. J Psychiatr Ment Health Nurs 2022; 29:317-326. [PMID: 33938079 DOI: 10.1111/jpm.12766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/19/2021] [Accepted: 04/23/2021] [Indexed: 01/29/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Some nurses develop positive relationships with people diagnosed with borderline personality disorder (BPD), while others have negative emotional reactions to people diagnosed with this disorder. The therapeutic relationship is key in the practice of mental health nursing. Enhanced knowledge of BPD allows mental health nurses to develop improved self-awareness, knowledge and understanding of the individuals and insight into the therapeutic challenges, which can improve attitudes towards people with this diagnosis. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We are lacking knowledge about the perspective of people diagnosed with BPD on the attitudes of mental health nurses that facilitate a positive therapeutic relationship. The perspective of people with a BPD diagnosis on the therapeutic relationship offers key information about the attitudes that they credit with supporting their recovery. The participants-people diagnosed with BPD-perceived that the following attitudes of mental health nurses reinforced the therapeutic relationship: confidence in the person's recovery, non-judgement, sense of humour, availability and humanity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study highlights mental health nurses' attitudes that participants perceived as having a positive effect on the therapeutic relationship. The recognition among people diagnosed with BPD of the constructive attitudes of mental health nurses may improve nurses' motivation to improve care for these patients. This study will allow mental health nurses to increase their awareness of the importance of attitude in the therapeutic relationship with people diagnosed with BPD. ABSTRACT: Introduction The therapeutic relationship between mental health nurses and people diagnosed with borderline personality disorder (BPD) is essential to successful treatment, and nurses' attitudes are a key component of this relationship. Some nurses develop positive therapeutic relationships with people diagnosed with BPD, while others have negative emotional reactions which in turn limit their ability to develop a positive therapeutic relationship. There is a gap in the literature with respect to how people diagnosed with BPD perceive the attitudes of mental health nurses that foster a positive therapeutic relationship. Aim To describe how people diagnosed with BPD who have experienced an improvement perceive the role of the attitudes of mental health nurses in building a positive therapeutic relationship. Method Qualitative descriptive design with 12 interviews; thematic content analysis. Results Participants identified five attitudes of mental health nurses as contributing to a positive therapeutic relationship: confidence in their ability to recover, non-judgement, humour, availability and humanity. Discussion Nurses' attitudes are key to the therapeutic relationship. It may be possible for nurses to improve their attitudes towards patients diagnosed with BPD through self-reflection. Implications for practice Mental health nurses should incorporate methods that explore attitudes and attitudinal development of the workforce.
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Affiliation(s)
- Maria Romeu-Labayen
- Adult Mental Health Center Horta Guinardó, Barcelona, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain
| | - Glòria Tort-Nasarre
- GREpS. Health Education Research Group, University of Lleida, Lleida, Spain.,Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - M Assumpta Rigol Cuadra
- Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain
| | - Rosa Giralt Palou
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Division of Mental Health, CNS, MSN, Althaia Foundation, Manresa, Spain
| | - Paola Galbany-Estragués
- AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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McKenzie K, Gregory J, Hogg L. Mental Health Workers' Attitudes Towards Individuals With a Diagnosis of Borderline Personality Disorder: A Systematic Literature Review. J Pers Disord 2022; 36:70-98. [PMID: 34124949 DOI: 10.1521/pedi_2021_35_528] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.
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Affiliation(s)
| | | | - Lorna Hogg
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, U.K
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10
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Attwood J, Wilkinson-Tough M, Lambe S, Draper E. Improving Attitudes Towards Personality Disorder: Is Training for Health and Social Care Professionals Effective? J Pers Disord 2021; 35:409-S4. [PMID: 31682190 DOI: 10.1521/pedi_2019_33_458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Health and social care professionals are more likely to hold negative attitudes towards people with a diagnosis of personality disorder than toward people with other mental health diagnoses. Negative attitudes have also been found to adversely impact care and service provision. This review sought to systemically evaluate training aimed at improving professional attitudes towards people with a diagnosis of personality disorder. Electronic databases PsychINFO, PubMed, Embase, Web of Science, and ProQuest were searched, and 19 articles were identified. Results show that training is effective and that improvements tend to be maintained. The results suggest that (1) co-production with people with personal experience of a personality disorder diagnosis, (2) communicating a psychological model to participants, and (3) teaching participants clinical skills for use in their work improve effectiveness. Further research in the form of randomized controlled trials that use validated measures and follow-up participants for at least 6 months is needed.
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Affiliation(s)
- Juliette Attwood
- Department of Clinical Psychology, University of Bath, Claverton Down, Bath, UK
| | | | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Erin Draper
- Department of Psychology, Loughborough University, Loughborough, Leicestershire, UK
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11
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O'Connell J, Pote H, Shafran R. Child mental health literacy training programmes for professionals in contact with children: A systematic review. Early Interv Psychiatry 2021; 15:234-247. [PMID: 32342663 DOI: 10.1111/eip.12964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 02/11/2020] [Accepted: 03/15/2020] [Indexed: 12/23/2022]
Abstract
AIMS There has been a surge in child mental health literacy training programmes for non-mental health professionals. No previous review has examined the effectiveness of child mental literacy training on all professionals in contact with children. METHODS Studies were identified through a systematic literature search of the Cochrane, EMBASE, Medline, and PsycINFO databases in February 2019. The review included studies that delivered training to professionals who have regular contact with young people aged 0 to 19 in the context of their role and at least one component of mental health literacy; (a) knowledge, (b) attitudes, (c) confidence in helping, (d) intention to help and (e) actual helping behaviour. The quality of papers was reviewed using the Cochrane revised Risk of Bias Tool for randomized controlled trials (RCTs) and the Integrated Quality Criteria for the Review of Multiple Study Designs for non RCTs. RESULTS Twenty-one studies met eligibility criteria (n = 3243). There was some evidence that global and specific child mental health literacy training improved professionals' knowledge and stigma-related attitudes towards mental health. Few studies investigated the impact of training on actual helping behaviour. CONCLUSION There may be value in providing child mental health literacy training to professionals in contact with children, however there is a need for studies to evaluate the long-term impact of such training, particularly on subsequent access to appropriate support. Findings raise concerns about the quality of the studies reported in the systematic review and recommendations are made for future studies.
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Affiliation(s)
- Jennifer O'Connell
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Helen Pote
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
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12
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Ntshingila N, Temane A, Poggenpoel M, Myburgh C. A model for psychiatric nurses to facilitate the mental health of women living with borderline personality disorder. Curationis 2021; 44:e1-e10. [PMID: 33567849 PMCID: PMC7876966 DOI: 10.4102/curationis.v44i1.2157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 09/19/2020] [Accepted: 10/31/2020] [Indexed: 11/05/2022] Open
Abstract
Background Borderline personality disorder (BPD) is characterised by emotional dysregulation, feelings of worthlessness, impulsivity, suicidality and poor relationships. As a result of the challenges in the treatment of women living with BPD and the lack of skills from the psychiatric nurse, there was a need to develop a model for psychiatric nurses to facilitate the mental health of women living with BPD. Objectives To describe the process that was followed in developing, describing and evaluating a model that could be used as a framework of reference for psychiatric nurses to facilitate the mental health of women living with BPD. Method A theory-generative, qualitative, exploratory, descriptive and contextual study design was used to develop the model. The central concept of the model was derived from a previous study: ‘The experiences of women living with borderline personality disorder’. The process entailed the identification of the central concept and other essential criteria, the classification of the central concepts and describing the relationships between the concepts. Results The central concept was identified as ‘facilitation of self-empowerment’ of women living with BPD. The concepts ‘facilitation’ and ‘self-empowerment’ were defined and classified. The identified and defined central concepts were placed into interrelated statements. The model to facilitate self-empowerment of women living with BPD was developed, described and evaluated. The model has not been implemented. Conclusion The model provides a framework of reference for psychiatric nurses to facilitate self-empowerment of women living with BPD.
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Affiliation(s)
- Nompumelelo Ntshingila
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg.
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Romeu-Labayen M, Rigol Cuadra MA, Galbany-Estragués P, Blanco Corbal S, Giralt Palou RM, Tort-Nasarre G. Borderline personality disorder in a community setting: service users' experiences of the therapeutic relationship with mental health nurses. Int J Ment Health Nurs 2020; 29:868-877. [PMID: 32304273 DOI: 10.1111/inm.12720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/03/2023]
Abstract
People with borderline personality disorder (BPD) suffer from severe symptoms and crises that put their lives at risk. BPD's symptoms make it difficult for nurses to establish good therapeutic relationships with people who suffer from it, thus hindering their recovery and contributing to stigma. We explored the experiences of people with BPD who were under the care of mental health nurses at a community mental health centre and who reported a reduction in distress. Our goal was to identify the actions and psychotherapeutic factors of the therapeutic relationship that people with BPD considered to be useful in their recovery. Our qualitative approach made it possible for us to learn about individual experiences and meanings and describe the perception of participants. Our sample included 12 participants. Data consisted of qualitative interviews with all participants and nursing records for six of the participants. We conducted an inductive thematic content analysis, resulting in a hierarchical system of subthemes and themes. We found that participants considered the following psychotherapeutic actions to be useful in recovery: learning about the disorder, building trust, and being empowered through validation.
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Affiliation(s)
- Maria Romeu-Labayen
- Adult Mental Health Center Horta Guinardó, Barcelona, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group at, Autonomus University of Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Maria Assumpta Rigol Cuadra
- Department of Public Health, Mental Health and Mother-Infant Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group at, Autonomus University of Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Paola Galbany-Estragués
- AFIN Research Group at, Autonomus University of Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.,Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
| | | | - Rosa Maria Giralt Palou
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Division of Mental Health, Althaia Foundation, Manresa, Spain
| | - Glòria Tort-Nasarre
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
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Stevenson C, Taylor J. Nurses' Perspectives of Factors That Influence Therapeutic Relationships in Secure Inpatient Forensic Hospitals. JOURNAL OF FORENSIC NURSING 2020; 16:169-178. [PMID: 32195758 DOI: 10.1097/jfn.0000000000000274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND The therapeutic relationship is synonymous with mental health nursing and fundamental to the provision of nursing care, regardless of the setting in which care is provided. This literature review examines, from a nursing perspective, factors influencing the formation and maintenance of therapeutic relationships in forensic mental health settings. METHODS A systematic search of the literature, using a range of electronic databases, focusing on nurse-patient therapeutic relationships in forensic settings was conducted. Articles were Critical Appraisal Skills Programme quality appraised, followed by a meta-aggregative thematic approach to data analysis and synthesis to identify themes and, finally, a production of an "action" policy statement. FINDINGS AND IMPLICATION FOR PRACTICE Eight articles met the criteria for review inclusion. Nine themes were identified; seven were categorized as internal/interpersonal factors, and two were categorized as external/environmental factors (with some themes interconnected). Synthesis of findings resulted in the production of a policy statement encouraging forensic mental health nurses to be aware of intrapersonal influences on therapeutic relationships and the need to provide a safe and supportive clinical environment for these relationships to form.
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Affiliation(s)
- Claire Stevenson
- Author Affiliation: School of Health & Life Sciences, University of the West of Scotland
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15
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Woloshyn V, Savage MJ. Features of YouTube ™ videos produced by individuals who self-identify with borderline personality disorder. Digit Health 2020; 6:2055207620932336. [PMID: 32587751 PMCID: PMC7294371 DOI: 10.1177/2055207620932336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/16/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives Many individuals use YouTube™ to seek out information and share first-hand experiences about mental illnesses, as well as to gain a sense of community. YouTube™ use may be especially appealing when offline supports are lacking or difficult to access, and when there is a fear of stigmatisation. Borderline personality disorder (BPD), also referred to as emotionally unstable personality disorder (EUPD), is a complex and often stigmatised mental-health disorder. The primary objective of this study was to describe the dominant messages that individuals who self-identify with the diagnosis of BPD present through YouTube™ videos. Methods The content analysis method was used to review 349 first-person YouTube™ uploads. Videos were coded for information regarding video and vlogger characteristics, video type, vlogger motivation and video content. Associations between video features including upload date and style and vlogger experience and motivation were examined. Results Findings indicate that more people who self-identify as being diagnosed with BPD are creating YouTube™ videos about their experiences, and these videos have shifted over time from being mostly anonymous multimedia productions to being monologues where the vlogger speaks directly to their audience. Discussions related to DSM-5 symptoms, treatment, effective coping and hope for the future are elements found in the uploads. Conclusion The nature and content of BPD first-person YouTube™ uploads has increased and changed over time. Increased awareness of these changes may assist mental-health practitioners to support clients and direct them to explore uploads that offer hope and promote engagement in help-seeking and effective coping behaviours.
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16
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Juurlink TT, Vukadin M, Stringer B, Westerman MJ, Lamers F, Anema JR, Beekman ATF, van Marle HJF. Barriers and facilitators to employment in borderline personality disorder: A qualitative study among patients, mental health practitioners and insurance physicians. PLoS One 2019; 14:e0220233. [PMID: 31335909 PMCID: PMC6650068 DOI: 10.1371/journal.pone.0220233] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 07/11/2019] [Indexed: 12/02/2022] Open
Abstract
Background Borderline personality disorder (BPD) is associated with unemployment and impaired functioning. However, a comprehensive understanding of barriers and facilitators to employment from a multidisciplinary perspective is currently lacking. Therefore, the aim of this qualitative study was to explore barriers and facilitators in gaining and maintaining employment in BPD from the perspectives of patients, mental health practitioners (MHPs) and insurance physicians (IPs). Methods Fifteen semi-structured interviews were conducted in patients with BPD and two focus groups were carried out among MHPs (n = 7) and IPs (n = 6) following a thematic content analysis approach. Results All participants described barriers and facilitators relating to three overall themes: characteristics of BPD, stigma, and support to employment. Barriers to employment mainly related to characteristics of BPD, such as low self-image, difficulty posing personal boundaries, difficulty regulating emotions, and lack of structure. MHPs and IPs additionally mentioned externalization and overestimation of competencies on the part of patients. Enhancing emotion regulation and self-reflection by successful treatment was suggested as a facilitator to enhance employment. Increasing collaboration between mental health and vocational rehabilitation services, and increasing knowledge about BPD, were suggested to increase sustainable employment and decrease stigma. Conclusions The present findings revealed that both facilitators and barriers are important in gaining and maintaining employment in BPD in which diminishing symptoms, examining stigma and increasing support to employment are key. As a next step, supported employment strategies that follow patient preferences and integrate employment and mental health services, should be studied in the context of BPD.
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Affiliation(s)
- Trees T. Juurlink
- Department of Psychiatry, Division of GGZ inGeest Specialized Mental Health Care, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- * E-mail:
| | - Miljana Vukadin
- Department of Social Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Barbara Stringer
- Centre for Consultation and Expertise (CCE), Utrecht, The Netherlands
| | - Marjan J. Westerman
- Department of Health Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Division of GGZ inGeest Specialized Mental Health Care, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes R. Anema
- Department of Social Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, Division of GGZ inGeest Specialized Mental Health Care, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hein J. F. van Marle
- Department of Psychiatry, Division of GGZ inGeest Specialized Mental Health Care, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Lamont E, Dickens GL. Mental health services, care provision, and professional support for people diagnosed with borderline personality disorder: systematic review of service-user, family, and carer perspectives. J Ment Health 2019; 30:619-633. [DOI: 10.1080/09638237.2019.1608923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Emma Lamont
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Geoffrey L. Dickens
- Division of Mental Health Nursing and Counselling, Abertay University, Dundee, UK
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18
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Acres K, Loughhead M, Procter N. Carer perspectives of people diagnosed with borderline personality disorder: A scoping review of emergency care responses. Australas Emerg Care 2019; 22:34-41. [PMID: 30998870 DOI: 10.1016/j.auec.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/05/2018] [Accepted: 12/05/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Caring for a person with borderline personality disorder remains largely stigmatised and misunderstood. When a crisis arises, carers often seek help with the person they care for in emergency care settings such as the emergency department. The aim of this review was to explore, locate and compile the literature regarding the perspectives of family carers for a person with borderline personality disorder in an emergency care setting with a focus on nursing practices. This review advances understandings of carer perspectives in emergency care settings. METHODS The Joanna Briggs Institute (2015) [1], methodology for scoping reviews guided this review. A search of Emcare, Medline and Ovid Nursing was performed during April 2018, to identify literature where carer views and perspectives on engaging with emergency care services were reported. A grey literature search was also conducted. A total of ten articles and reports were included in this review. Consultation with a carer support group precipitated this review, which assisted in the formulation of the research questions. RESULTS Papers found via the study focused on health professional responses, rather than on nursing practice. Findings indicate that carers often perceive emergency departments as the only option for emergency care in a crisis. Carers require information about how to effectively manage a crisis with their loved one more effectively. CONCLUSION This scoping review identified that carers are often not consulted or engaged with by health professionals. Carers often perceive that nurses and health professionals have a lack understanding about the consumer's conceptualisation of distress and the nature of BPD, which becomes a barrier to effective crisis support and management. The literature often reported that a trusting and collaborative relationship between carers, nurses and health professionals demonstrated improved outcomes for the carer and consumer.
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Affiliation(s)
- Kristy Acres
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide SA 5000, Australia.
| | - Mark Loughhead
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide SA 5000, Australia.
| | - Nicholas Procter
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide SA 5000, Australia.
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Dickens GL, Lamont E, Mullen J, MacArthur N, Stirling FJ. Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder. J Clin Nurs 2019; 28:2613-2623. [DOI: 10.1111/jocn.14847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/26/2018] [Accepted: 12/17/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Emma Lamont
- School of Health and Social Sciences Abertay University Dundee UK
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20
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Welstead HJ, Patrick J, Russ TC, Cooney G, Mulvenna CM, Maclean C, Polnay A. Mentalising skills in generic mental healthcare settings: can we make our day-to-day interactions more therapeutic? BJPsych Bull 2018; 42:102-108. [PMID: 29681246 PMCID: PMC6048730 DOI: 10.1192/bjb.2017.29] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Aims and methodCaring for patients with personality disorder is one of the biggest challenges in psychiatric work. We investigated whether mentalisation-based treatment skills (MBT-S) teaching improves clinicians' understanding of mentalising and attitudes towards personality disorder. Self-report questionnaires (Knowledge and Application of MBT (KAMQ) and Attitudes to Personality Disorder (APDQ)) were completed at baseline and after a 2-day MBT-S workshop. RESULTS Ninety-two healthcare professionals completed questionnaires before and after training. The mean within-participant increase in scores from baseline to end-of-programme was 11.6 points (95% CI 10.0-13.3) for the KAMQ and 4.0 points (1.8-6.2) for the APDQ.Clinical implicationsMBT-S is a short intervention that is effective in improving clinicians' knowledge of personality disorder and mentalisation. That attitudes to personality disorder improved overall is encouraging in relation to the possibility of deeper learning in staff and, ultimately, improved care for patients with personality disorder.Declaration of interestNone.
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Affiliation(s)
| | | | - T C Russ
- Royal Edinburgh Hospital,Edinburgh,UK
| | - G Cooney
- Gartnavel Royal Hospital,Glasgow,UK
| | | | - C Maclean
- Royal Edinburgh Hospital,Edinburgh,UK
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21
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Limandri BJ. Psychopharmacology for Borderline Personality Disorder. J Psychosoc Nurs Ment Health Serv 2018; 56:8-11. [DOI: 10.3928/02793695-20180319-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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He Z, Cheng Z, Shao T, Liu C, Shao P, Bishwajit G, Feng D, Feng Z. Factors Influencing Health Knowledge and Behaviors among the Elderly in Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100975. [PMID: 27706061 PMCID: PMC5086714 DOI: 10.3390/ijerph13100975] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/06/2016] [Accepted: 09/26/2016] [Indexed: 11/16/2022]
Abstract
Objectives: Health knowledge and behaviors are the key elements that ensure high quality of health for the elderly. This study explored and determined the conditions and factors of health knowledge and behaviors that affect the elderly in rural China. Methods: A cross-sectional research approach and random stratified sampling method were used in 12 towns and 48 villages in the Chongqing Municipality, Henan, and Zhejiang Provinces in China from June to September 2013. The collected data included: (1) socio-demographic characteristics of 1593 elderly people; (2) accuracy rate on health knowledge of the elderly, which was analyzed and compared among the three sample areas by using Chi-square test; and (3) mean scores on the health behaviors of the elderly, which were analyzed and compared by using analysis of variance (ANOVA). The multiple-linear regression method was used to analyze the factors affecting the health knowledge and behaviors of the elderly. Results: Significant differences were observed among the nine items in the health knowledge questionnaire (p = 0.000 < 0.001). The average accuracy rate of the nine items was 57.43%. Significant differences were observed among the eleven items on the health behaviors of the elderly in the sample rural areas (p = 0.000 < 0.001). Age, economic level, degree of education, distance from home to medical institutions and disposable personal income (DPI) can affect the scores of the health knowledge and behaviors of the elderly (p = 0.000 < 0.001). Conclusions: Lack of health knowledge and poor health behaviors are common among the elderly in the sample areas of rural China. This deficiency poses a serious threat on the promotion of health conditions and the improvement of the level of health quality among the elderly. Different types of access to sources of health knowledge should be used to increase health knowledge scores of the elderly. Various potential intervening measures should also be adopted to improve their health behaviors of elderly people.
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Affiliation(s)
- Zhifei He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Zhaohui Cheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Tian Shao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Chunyan Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Piaopiao Shao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Da Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
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Dickens GL, Lamont E, Gray S. Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review. J Clin Nurs 2016; 25:1848-75. [DOI: 10.1111/jocn.13202] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Geoffrey L Dickens
- Division of Mental Health Nursing and Counselling; Abertay University; Dundee UK
- NHS Fife Research and Development Department; Queen Margaret Hospital; Dunfermline UK
| | - Emma Lamont
- Division of Mental Health Nursing and Counselling; Abertay University; Dundee UK
| | - Sarah Gray
- NHS Fife Research and Development Department; Queen Margaret Hospital; Dunfermline UK
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