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Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

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  • Geoffrey L Dickens
  • Emma Lamont
  • Sarah Gray

Abstract

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter‐therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter‐therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence‐based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team‐wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.

Suggested Citation

  • Geoffrey L Dickens & Emma Lamont & Sarah Gray, 2016. "Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(13-14), pages 1848-1875, July.
    • Handle: RePEc:wly:jocnur:v:25:y:2016:i:13-14:p:1848-1875
    DOI: 10.1111/jocn.13202
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    References listed on IDEAS

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    1. Bridget McGrath & Maura Dowling, 2012. "Exploring Registered Psychiatric Nurses' Responses towards Service Users with a Diagnosis of Borderline Personality Disorder," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-10, April.
    2. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
    3. Herschell, Amy D. & Lindhiem, Oliver J. & Kogan, Jane N. & Celedonia, Karen L. & Stein, Bradley D., 2014. "Evaluation of an implementation initiative for embedding Dialectical Behavior Therapy in community settings," Evaluation and Program Planning, Elsevier, vol. 43(C), pages 55-63.
    4. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Geoffrey L. Dickens & Emma Lamont & Jo Mullen & Nadine MacArthur & Fiona J. Stirling, 2019. "Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(13-14), pages 2613-2623, July.

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