Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, UK.
SS Psychological Services, Carlisle, Cumbria, UK.
Br J Clin Psychol. 2018 Nov;57(4):473-490. doi: 10.1111/bjc.12180. Epub 2018 Apr 16.
This study was the first to explore how staff that work with people diagnosed with borderline personality disorder (BPD) perceive recovery in this client group. These views are important because of the crucial role that staff play in the care of people with BPD, and the challenges that staff experience with these clients.
A Q methodology design was used, containing 58 statements about recovery.
Twenty-nine mental health staff sorted recovery statements according to perceived importance to recovery in BPD.
There were two different viewpoints about recovery in BPD. A medically oriented group viewed coping with symptoms and behaviours specific to BPD as being most important to recovery, whereas participants who were more well-being oriented viewed achieving overall well-being that was universally valued regardless of diagnosis as more important. Both groups reported that engaging in socially valued activities such as work and education was not an important aspect of recovery and that people with BPD could be considered to have recovered despite continued impairments in everyday functioning.
Staff perceptions of recovery in BPD can differ, which poses risks for consistent team working, a particularly important issue in this client group due to the relational difficulties associated with the diagnosis. Multidisciplinary teams working with people diagnosed with BPD therefore need to find a forum to promote a shared understanding of each patient's needs and support plans. We advocate that team formulation is a promising approach to achieve more consistent ways of working within teams.
Findings Multidisciplinary teams working with people with borderline personality disorder should use team formulations to create a shared understanding of individual patient's needs and goals for recovery, so they can deliver a consistent approach to care. Recovery questionnaires should be used to develop an understanding of a patient's individual recovery goals. Limitations Opportunity sampling was utilized in recruitment, and the sample was not representative of the general population of staff working with borderline personality disorder. Although views from a wide range of professions were sampled in this research, the views of psychiatrists were not represented.
本研究首次探讨了与被诊断为边缘型人格障碍（BPD）的患者一起工作的工作人员如何看待该人群的康复。这些观点很重要，因为工作人员在 BPD 患者的护理中扮演着至关重要的角色，并且他们在与这些患者打交道时会遇到各种挑战。
采用 Q 方法设计，包含 58 条关于康复的陈述。
29 名心理健康工作人员根据对 BPD 康复的重要性对康复陈述进行排序。
BPD 中有两种不同的康复观点。以医学为导向的群体认为应对 BPD 特有的症状和行为是康复的最重要因素，而以健康为导向的参与者则认为实现普遍重视的整体健康更为重要，无论诊断如何。这两个群体都报告说，从事有社会价值的活动，如工作和教育，并不是康复的重要方面，而且尽管日常生活功能持续受损，BPD 患者仍可被认为已经康复。
工作人员对 BPD 康复的看法可能存在差异，这对团队的一致性工作构成了风险，而在这个患者群体中，由于与诊断相关的关系困难，这是一个特别重要的问题。因此，与被诊断为 BPD 的患者合作的多学科团队需要找到一个论坛，以促进对每个患者需求和支持计划的共同理解。我们主张，团队构象是实现团队内更一致工作方式的一种有前途的方法。
研究结果与边缘型人格障碍患者合作的多学科团队应使用团队构象来创建对个别患者康复需求和目标的共同理解，以便他们能够提供一致的护理方法。应使用康复问卷来了解患者的个体康复目标。局限性机会抽样用于招募，且样本不能代表与边缘型人格障碍患者一起工作的一般工作人员群体。尽管本研究中采样了来自广泛专业的观点，但没有代表精神科医生的观点。
