Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada.
Addiction and Mental Health, Alberta Health Services, Edmonton, Alberta, Canada.
PLoS One. 2022 Sep 22;17(9):e0274197. doi: 10.1371/journal.pone.0274197. eCollection 2022.
The diagnosis of borderline personality disorder (BPD) consists of extreme emotional dysregulation and long-term disability when left untreated. It is associated with ineffective use of health care systems and mismanaged care in emergency departments, which can result in a revolving door phenomenon of urgent system usage, poor treatment outcomes, or patients falling out of care entirely-all of which primarily affect patients with BPD as well as their caregivers and clinicians. This crisis must be addressed with a comprehensive understanding of key stakeholder perspectives on the challenges of the system and potential solutions.
This study explored the perspectives of three key stakeholder groups (i.e., patients, clinicians, and caregivers) in relation to their experiences with and future expectations of the care system for those affected by BPD.
Four patients with BPD, three generalist clinicians with experience treating BPD, and three caregivers of individuals with BPD participated in individual semi-structured interviews. Participants were asked about their experiences with the current healthcare system and their suggestions for improvement. Responses were analyzed using interpretative phenomenological analysis.
In-depth analysis of the qualitative data revealed twelve shared themes and three themes that were unique to each key stakeholder group. These themes are discussed and used to inform recommendations for promising practices, policies, and training in this area.
Findings support the importance of a comprehensive mental health system approach for improving the accessibility, effectiveness, and acceptability of the management and treatment of BPD.
未经治疗的边缘型人格障碍（BPD）的诊断包括极端的情绪失调和长期残疾。它与医疗保健系统的低效使用以及急诊科的护理管理不善有关，这可能导致紧急系统使用的恶性循环现象、治疗效果不佳或患者完全脱离护理——所有这些主要影响 BPD 患者以及他们的照顾者和临床医生。必须全面了解关键利益相关者对系统挑战和潜在解决方案的看法，才能解决这一危机。
本研究探讨了三个关键利益相关者群体（即患者、临床医生和照顾者）对受 BPD 影响者的护理系统的体验和未来期望的观点。
四名 BPD 患者、三名有治疗 BPD 经验的全科医生和三名 BPD 患者的照顾者参加了个体半结构化访谈。参与者被问及他们对当前医疗保健系统的体验以及改善系统的建议。使用解释性现象学分析对响应进行了分析。
对定性数据的深入分析揭示了十二个共同主题和三个每个关键利益相关者群体特有的主题。讨论了这些主题，并用于为该领域的有前途的实践、政策和培训提供建议。
研究结果支持综合心理健康系统方法的重要性，以提高 BPD 的管理和治疗的可及性、有效性和可接受性。
