Mental Health Nurses' Understanding of the Concept of Self-Management of Borderline Personality Disorder
BACKGROUND The recovery framework is held as a mainstay in mental health to guide clinical practice. One of the main concepts of the framework is self-management. Borderline personality disorder (BPD) is arguably the most stigmatized diagnosis within mental health nursing. While mental health nurses appear to have embraced the recovery framework, they have struggled to apply this framework to nursing practice for people with a diagnosis of BPD. AIM The objective of this study was to determine what mental health nurses understood the concept of self-management to mean in relation to a service user with a diagnosis of BPD. METHOD A sample of ten mental health nurses working within a large District Health Board Specialist Mental Health Services was interviewed using a semi-structured interview format. The data generated from these interviews was analysed using the general inductive approach resulting in 26 sub-themes. These sub-themes were the varying concepts that participants understood to be self-management and were organised into three over-arching themes. RESULTS The three resulting themes from the study were: self-management is self-responsibility; second, that self-management is self-awareness; and third, that self-management is maintaining safety. CONCLUSION The three themes represented the diverse understanding of self-management held by the study participants. The first and second themes, self-management is self-responsibility and self-management is increasing self-awareness, both fit with the recovery philosophy of client empowerment and required nurses to move from the paternalistic, dominant, medical model. The third theme, self-management is maintaining safety, did not fit with the recovery model. Nurses practicing with a goal of maintaining client safety as self-management, have yet to break free from the aforementioned parochial model and question the use of power employed as well as the goal of their practice. Nurses may have been unaware of the underlying beliefs and assumptions that have shaped their practice and may benefit from a reflective style of supervision. Nurses’ understanding of the concept of self-management for people with a diagnosis of borderline personality disorder was embedded in their practice and influenced the roles that they and the person played in their recovery journey.
Advisor: Whitehead, Lisa; Carlyle, Dave
Degree Name: Master of Health Sciences
Degree Discipline: Department of Post Graduate Nursing Otago University
Publisher: University of Otago
Keywords: self-management; mental; health; nursing; borderline; personality; disorder
Research Type: Thesis