Adult Inpatient Psychology, Berrywood Hospital, Duston, UK.
Birmingham Newman University, Birmingham, UK.
J Psychiatr Ment Health Nurs. 2024 Oct;31(5):803-814. doi: 10.1111/jpm.13032. Epub 2024 Feb 13.
WHAT IS KNOWN ON THE SUBJECT?: We know that there are similar rates of borderline personality disorder (BPD) diagnosed in both men and women; however, some research suggests that BPD is diagnosed later and less frequently in men. Some research suggests that males diagnosed with BPD present differently to women, but not much is known about how this influences the care men receive in inpatient mental health hospitals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper is the first to specifically ask inpatient staff about men diagnosed with BPD, and to hear about their perceptions and experiences. It identified that some staff do not feel as knowledgeable in identifying and treating BPD in men compared to women. Some staff talked about how emotional difficulties like BPD are often not the first thought when men present with distress compared to women. Staff also talked about needing a safe, open and transparent working culture to be able to ask questions and to be questioned on their own assumptions, biases or lack of training. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper suggests that inpatient staff may hold some assumptions about men and their emotions, such as assuming that they are less likely to struggle with emotional difficulties like BPD. Staff anxieties about risk management may influence how they perceive and care for men in inpatient wards. The findings suggest that male-specific training in identifying and treating BPD should be provided for staff on inpatient wards, to improve knowledge and confidence.
INTRODUCTION: Research highlights discrepancies in recognition of borderline personality disorder (BPD) in men, despite similar rates of prevalence across genders.
To investigate inpatient mental health professionals' experiences of delivering treatment for males with a diagnosis of BPD.
Six mental health professionals working within adult acute inpatient wards completed a semi-structured interview. All participants were members of the nursing team. Thematic analysis was used to analyse the data.
Five themes were identified: Gender Differences, Stereotyping, Facilitators to Care Delivery, Barriers to Care Delivery and Ways to Improve Care. Participants talked of a lack of awareness and understanding of BPD in males impacting both diagnosis and treatment in an acute inpatient setting.
There may be factors ranging from gender stereotypes, limited knowledge and understanding of gender differences in presentations, and personal/organisational cultures influencing the formulation and treatment of males with a diagnosis of BPD in inpatient settings.
The findings suggest that gender stereotypes such as masculine norms may influence how male patients' emotional difficulties are understood and managed, and that additional training in male-specific issues to improve knowledge and care provision. This research will support inpatient staff, service leads and clinical educators to identify ways to adapt care provision for men.
调查精神科住院医师在治疗男性 BPD 患者时的体验。
对六名在成人急性住院病房工作的心理健康专业人员进行半结构式访谈。所有参与者均为护理团队成员。采用主题分析方法对数据进行分析。
确定了五个主题：性别差异、刻板印象、促进护理提供、护理提供的障碍和改善护理的方法。参与者表示，男性对 BPD 的认识和理解不足，这对急性住院环境中的诊断和治疗都有影响。
从性别刻板印象、对表现中性别差异的认识和理解有限以及个人/组织文化等因素，可能会影响 BPD 男性患者的诊断和治疗。
研究结果表明，性别刻板印象（如男子气概的规范）可能会影响男性患者的情绪困难的理解和管理，并且需要额外的男性特定问题培训，以提高知识和护理水平。这项研究将支持住院工作人员、服务负责人和临床教育者确定如何为男性调整护理服务。
