Attitudes of registered psychiatric nurses towards patients diagnosed with borderline personality disorder

Abstract

Caring for patients with a diagnosis of Borderline Personality Disorder (BPD) has been identified as a problem area for mental health professionals with some studies suggesting that a diagnosis of BPD will influence the level and quality of interaction staff have with patients. It is inherent to psychiatric nursing that practitioners are able to establish rapport, develop trust and demonstrate empathy with consumers of mental health services. Despite the importance of this issue for psychiatric nurses and for consumers, the perceptions and attitudes of psychiatric nurses towards patients diagnosed with BPD have received almost no research attention. This paper describes findings from a study of attitudes held by 65 registered nurses employed in a psychiatric inpatient unit and psychiatric community service where individuals with a DSM-IV diagnosis of BPD received treatment. In particular, findings relating to Clinical Description, Emotional Reactions, Concerns and Management of patients with BPD are reported. Results show that a proportion of psychiatric nurses experience negative emotional reactions and attitudes toward people with BPD with the majority of nurses perceiving people with BPD as manipulative, almost one third reporting that patients with BPD made them angry and over one third either 'strongly disagreed' or 'disagreed' that they know how to care for people with BPD. Although psychiatric nurses face many challenges in providing care for patients with BPD, it is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them. Further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD.

People with a borderline personality disorder diagnosis describe discriminatory experiences

“…The research indicates that health staff tend to have strong reactions to this diagnosis, with more negative attitudes (compared to various other psychiatric diagnoses) and with less empathy (Fraser & Gallop 1993;Markham 2003;Filer 2005;Aviram et al 2006;Deans & Meocevic 2006;Commons Treloar & Lewis 2008a;Westwood & Baker 2010;Black et al 2011). …”

“…Others discuss how the symptoms and behaviour associated with BPD may lead to strong emotional reactions from healthcare staff (Gallop et al 1989;Deans & Meocevic 2006;Commons Treloar & Lewis 2008a). One part of BPD diagnostic criteria is intense, unstable relationships and conflict (American Psychiatric Association 2000, 2013.…”

Community mental healthcare for people with severe personality disorder: narrative review

“…On the contrary, in daily practice it is often associated with long-term care lacking clear aims and therapeutic ambitions, 10 possibly resulting in unnecessary dependency. In addition, negative professional attitudes towards patients with personality disorders have been reported frequently, [11][12][13] possibly resulting in an ineffective patient-professional interaction, especially in long-term supportive care. Therefore, we aim to answer the following questions in this review: what, exactly, is CMHC for severe personality disorder; who provides it; how does it compare with other forms of treatment for this disorder; what are its empirical and theoretical underpinnings; and what are its strengths and limitations?…”

Nursing staff attitudes towards patients with personality disorder

“…Lewis and Appleby (1988) gave 173 psychiatrists case vignettes of patients diagnosed with PD or not, and found that the PD patients were seen as manipulative, attention seeking, annoying, and in control of their suicidal urges. Deans and Meocevic (2006) studied 65 registered nurses with at least one year's experience in services treating patients with a diagnosis of borderline PD (BPD). Their 50-item questionnaire examined nurses' clinical descriptions of patients with BPD, their emotional reactions, concerns and opinions about management.…”