Liaison Psychiatry, Connolly Hospital, Dublin 15, Ireland.
School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland.
Int J Ment Health Nurs. 2022 Feb;31(1):83-90. doi: 10.1111/inm.12935. Epub 2021 Sep 25.
The diagnosis of borderline personality disorder (BPD) has been found to carry stigma and poor hope of recovery. More recently, it has been regarded as a treatable condition through psychotherapy. Despite this, patients often experience lengthy hospitalizations, limited access to treatment, and poor outcomes. This paper describes the experiences of psychiatric nurses working with people diagnosed with BPD in acute mental health in-patient settings in Ireland. Seven nurses were interviewed, and the transcripts were analysed using a reflective and inductive approach. Overall, the nurses did not feel confident that their interventions were effective or valued by the wider service or patients. The nurses articulated their invidious professional circumstances, whereby they were required to act in ways, which ran counter to their vision of therapeutic or recovery-focused work. These views and perceptions that in-patient care is often ineffectual are widely echoed in the literature. We contend that the effect of this circumstance for these nurses approaches moral distress. The nurses were aware of more effective methods of care and treatment for BPD but perceived that they were unable to influence the culture of in-patient care.
边缘型人格障碍（BPD）的诊断被发现带有耻辱感，且康复希望渺茫。最近，人们认为通过心理治疗可以治疗这种疾病。尽管如此，患者通常还是会经历长时间的住院治疗、有限的治疗机会和较差的治疗效果。本文描述了在爱尔兰急性精神科住院环境中工作的精神科护士与被诊断为 BPD 的患者的相处经历。对 7 名护士进行了访谈，使用反思和归纳的方法对转录本进行了分析。总的来说，护士们并不认为他们的干预措施是有效的，也不认为他们的干预措施受到更广泛的服务或患者的重视。护士们表达了他们不利的职业环境，即他们被要求采取与他们对治疗或以康复为重点的工作的看法背道而驰的方式。这种对住院治疗通常无效的观点和看法在文献中得到了广泛的呼应。我们认为，这种情况下对这些护士的影响接近道德困境。护士们了解到 BPD 的更有效治疗方法和治疗手段，但认为他们无法影响住院治疗的文化。
