Helping interactions with patients with borderline personality disorder on admission wards, a qualitative study

Abstract

Background: The contact between patients with BPD and mental health nurses (MHN-s), on psychiatric admission wards, is at risk to evolve into ongoing ineffective interactions. To reduce this risk, insight in experiences and perceptions of BPD patients on admission wards should be used. Herein, previous studies provide a lack of insight. Aims and research questions: This study aims to provide insight in what interactions with MHN-s are perceived helping by patients with BPD on acute admissions wards. This insight can be used in practice and in training of MHN-s. The primary question is: ‘what interactions with MHN-s do patients with BPD perceive as helping to achieve their goal of hospitalization?’. Method: Semi-structured in-depth interviews were conducted with twelve participants after discharge from one of the six participating admission wards. A grounded theory approach was used to develop thematic descriptions of patients’ experiences and perceptions of helping responses. Results: Half of the patients perceived ‘coming to rest’ as the goal of hospitalization. Three themes emerged with regard to what interactions with MHN-s are perceived helping to achieve the goal of hospitalization: ‘help patients to ask for help’, ‘understand the patient as a person’ and ‘help patients to identify what they need’. Conclusion: This study provides insight in interactions with MHN-s that patient perceive as helping. This insight can help MHN-s to prevent negative effects of hospitalization and establish effective interactions with them. Recommendations: It is recommended to communicate open and clear about what patients can expect, to make use of the good contact that many patients have with a few of the MHN-s and to evaluate with patients the care that is given.