TY - JOUR
T1 - Mental health nurses' attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder
T2 - Systematic, integrative literature review
AU - Dickens, Geoffrey L.
AU - Lamont, Emma
AU - Gray, Sarah
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Aims and objectives: To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background: There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Design: Systematic, integrative literature review. Methods: Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results: Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions: Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice: There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.
AB - Aims and objectives: To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background: There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Design: Systematic, integrative literature review. Methods: Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results: Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions: Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice: There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.
KW - Attitudes
KW - Borderline personality disorder
KW - Education
KW - Emotionally unstable personality disorder
KW - Experience
KW - Knowledge
KW - Mental health nurse
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84971455009&partnerID=8YFLogxK
U2 - 10.1111/jocn.13202
DO - 10.1111/jocn.13202
M3 - Review article
C2 - 27139693
AN - SCOPUS:84971455009
VL - 25
SP - 1848
EP - 1875
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
SN - 0962-1067
IS - 13-14
ER -