Suppr超能文献

有边缘型人格障碍(BPD)诊断的患者对 BPD 管理的看法-澳大利亚 NHMRC BPD 指南在实践中的实施情况如何?

Consumer perspective from people with a diagnosis of Borderline Personality Disorder (BPD) on BPD management-How are the Australian NHMRC BPD guidelines faring in practice?

机构信息

Behavioural Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

Lived Experience Australia, Marden, SA, Australia.

出版信息

J Psychiatr Ment Health Nurs. 2021 Aug;28(4):670-681. doi: 10.1111/jpm.12714. Epub 2020 Nov 30.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Internationally, stigma towards people with mental illness has reduced due to greater understanding, education and advocacy in the community, and more focus on recovery-oriented care within practice guidelines. However, many people with a diagnosis of BPD continue to experience stigma and difficulty accessing health services. Contributing factors include lack of understanding of BPD and effective management by health professionals, stigma from the general population and within healthcare services, and financial and geographical barriers. Mental health nurses comprise a large part of the healthcare workforce responsible for the day-to-day care of people diagnosed with BPD. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: This paper investigates how Australian consumer perspectives on BPD management have changed over time. Comments from a large survey, delivered to consumers in 2011 (N = 153) and 2017 (N = 424), were analysed for common themes. Themes were broadly related to NHMRC BPD Guidelines sections released in 2013. These data sets therefore present an opportunity to evaluate changes in consumer perspectives pre- and post-Guideline release. Although no direct causal relationship can be drawn, analysing these changes can potentially assist with understanding the impact of the Guidelines in practice. No such analysis of the Australian Guidelines has been conducted to date in the existing literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Many people diagnosed with BPD continue to experience stigma, barriers to treatment and difficulty accessing appropriate services. Widespread practical implementation of the Guidelines was not apparent; however, improved general awareness and understanding of BPD from consumers and health professionals were evident. Improved education and practice across each and all aspects of the Guidelines are indicated. The Guidelines need review to ensure they are in-line with current evidence-based practice, as well as effective health professional education, support and funding to embed the revised Guidelines into practice. ABSTRACT: Introduction Internationally, many individuals diagnosed with BPD continue to experience stigma within health care and are more likely to be viewed as manipulative and evoke negative responses from clinicians, compared with other mental health consumers. Aim/Question To understand Australian consumer perspectives regarding BPD management, and how these have changed between 2011 and 2017. To comment on how NHMRC BPD Guidelines, released 2013, are faring in practice. Method Individuals who identified a BPD diagnosis completed a 75-question survey, delivered online Australia-wide, in 2011 (N = 153) and 2017 (N = 424), providing comparative data sets to evaluate changes in consumer perspective on BPD management. Results Many people diagnosed with BPD experience difficulties when seeking help, stigma within health services and barriers to treatment. Improved general awareness, communication and understanding of BPD from consumers and health professionals were evident. Discussion Consumers demonstrated increased BPD-literacy and help-seeking behaviours in 2017, providing opportunity for health professionals to build stronger therapeutic relationships. Widespread practical implementation of the Guidelines does not appear to have been achieved. More health professional education, updated Guidelines, funding and strategies to embed these Guidelines into practice are needed. Implications for Practice Mental health nurses regularly provide care to people diagnosed with BPD; with practical education and support, they and other health professionals can improve their confidence in practice and provide better quality care to consumers.

摘要

已知信息:在国际上,由于社区内对精神疾病患者的理解、教育和宣传的增加,以及实践指南中对以康复为导向的护理的更多关注,对精神疾病患者的污名化有所减少。然而,许多被诊断为边缘型人格障碍的人继续经历污名化和难以获得卫生服务。促成因素包括卫生专业人员对 BPD 的理解和有效管理的缺乏、普通民众和医疗保健服务中的污名化、经济和地理障碍。精神科护士构成了负责日常护理被诊断为 BPD 的人的医疗保健人员的很大一部分。

本研究新增信息:本文调查了澳大利亚消费者对 BPD 管理的看法随着时间的推移发生了怎样的变化。对 2011 年(N=153)和 2017 年(N=424)向消费者提供的一项大型调查的评论进行了分析,以寻找共同的主题。主题大致与 2013 年发布的 NHMRC BPD 指南部分相关。因此,这些数据集提供了一个机会,可以评估指南发布前后消费者观点的变化。虽然不能直接得出因果关系,但分析这些变化可能有助于了解指南在实践中的影响。在现有文献中,尚未对澳大利亚指南进行过此类分析。

对实践的影响:许多被诊断为 BPD 的人继续经历污名化、治疗障碍和难以获得适当的服务。广泛实施指南的情况并不明显;然而,消费者和卫生专业人员对 BPD 的一般认识和理解明显提高。需要对指南的所有方面进行更广泛的教育和实践改进。指南需要审查,以确保它们与当前循证实践以及有效的卫生专业人员教育、支持和资金保持一致,以将修订后的指南纳入实践。

摘要:介绍:在国际上,许多被诊断患有 BPD 的人在医疗保健中仍继续面临污名化,并比其他心理健康消费者更容易被视为操纵者,并引起临床医生的负面反应。目的/问题:了解澳大利亚消费者对 BPD 管理的看法,以及这些看法在 2011 年至 2017 年期间发生了怎样的变化。评论 2013 年发布的 NHMRC BPD 指南在实践中的表现。方法:自我报告 BPD 诊断的个人完成了一项 75 个问题的在线调查,在澳大利亚全国范围内在线提供,2011 年(N=153)和 2017 年(N=424)提供了比较数据集,以评估消费者对 BPD 管理看法的变化。结果:许多被诊断患有 BPD 的人在寻求帮助时遇到困难,在卫生服务中面临污名化,并面临治疗障碍。消费者和卫生专业人员对 BPD 的认识、沟通和理解明显提高。讨论:消费者在 2017 年表现出了更高的 BPD 素养和寻求帮助的行为,为卫生专业人员提供了建立更强治疗关系的机会。指南的广泛实际实施似乎尚未实现。需要更多的卫生专业人员教育、更新的指南、资金和将这些指南纳入实践的策略。对实践的影响:精神科护士经常为被诊断为 BPD 的人提供护理;通过实际教育和支持,他们和其他卫生专业人员可以提高他们在实践中的信心,并为消费者提供更好的护理质量。

相似文献

2
Experiences of care by Australians with a diagnosis of borderline personality disorder.
J Psychiatr Ment Health Nurs. 2015 Sep;22(7):510-21. doi: 10.1111/jpm.12226. Epub 2015 Jun 30.
3
Perspectives of culturally and linguistically diverse (CALD) community members regarding mental health services: A qualitative analysis.
J Psychiatr Ment Health Nurs. 2023 Aug;30(4):850-864. doi: 10.1111/jpm.12919. Epub 2023 Mar 22.
4
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 Apr;29(2):317-326. doi: 10.1111/jpm.12766. Epub 2021 May 17.
5
Anti-stigma initiatives for mental health professionals-A systematic literature review.
J Psychiatr Ment Health Nurs. 2022 Aug;29(4):512-528. doi: 10.1111/jpm.12840. Epub 2022 May 16.
8
Inpatient staff experiences of providing treatment for males with a diagnosis of borderline personality disorder: A thematic analysis.
J Psychiatr Ment Health Nurs. 2024 Oct;31(5):803-814. doi: 10.1111/jpm.13032. Epub 2024 Feb 13.
9
Perspectives of crisis intervention for people diagnosed with "borderline personality disorder": An integrative review.
J Psychiatr Ment Health Nurs. 2021 Apr;28(2):208-236. doi: 10.1111/jpm.12637. Epub 2020 May 5.

本文引用的文献

1
European guidelines for personality disorders: past, present and future.
Borderline Personal Disord Emot Dysregul. 2019 May 21;6:9. doi: 10.1186/s40479-019-0106-3. eCollection 2019.
7
Impact of Diagnosis Disclosure on Adolescents with Borderline Personality Disorder.
J Can Acad Child Adolesc Psychiatry. 2016 Fall;25(3):177-184. Epub 2016 Nov 1.
8
Improving patient-centered communication of the borderline personality disorder diagnosis.
J Ment Health. 2016;25(1):5-9. doi: 10.3109/09638237.2015.1022253. Epub 2015 Sep 11.
9
Borderline personality disorder in adolescence.
Pediatrics. 2014 Oct;134(4):782-93. doi: 10.1542/peds.2013-3677. Epub 2014 Sep 22.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验