Whats Borderline Personality Disorder Nursing Essay
The aim of this dissertation is to investigate whether education on borderline personality disorder (BPD) is helpful in improving the care and management of people with a diagnosis of BPD by causing an attitudinal change in staff.
What is Borderline Personality Disorder?
The ICD-10 (WHO 2010) and DSM-IV-TR (APA 2000) collectively describe BPD as a mental disorder whose symptoms include “frantic efforts to avoid abandonment, disturbance of self-image, impulsivity without considering consequences, transient paranoid ideation, an impairment of psychosocial functioning with a tendency towards self-destructive behaviour, including self-harm and suicide and mood instability with aggressive emotional outbursts” (APA 2000, WHO 2010).
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Get Help Now!BPD has both an environmental and biological basis (Bokian 2002, National Institute for Health and Clinical Excellence (NICE) 2009). Up to 66% of BPD patients have a psychosocial history of childhood abuse, with sexual abuse mostly implicated (Bokian 2002, Linehan 1993, National Collaborating Centre for Mental Health (NCCMH) 2009).
One of the core problems within BPD is emotional dysregulation. Oversensitivity to emotional stimuli manifests within the fronto-limbic system of the brain via the neurotransmitter serotonin (Ruocco et al 2012). This inhibits the ability to regulate destructive urges, aggression and affect (NCCMH 2009, Royal College of Psychiatrists (RCP) 2009)……………………………
Working with BPD; what are the challenges?
BPD generates a large amount of distress for both the patient, and those nursing them. Psychological distress is experienced with this disorder, which is usually managed by the use of dysfunctional coping mechanisms such as drug addiction, risky sexual encounters and self-harm (McVey & Murphy 2010).
In the area of staff attitudes towards patients with BPD, the focus of care is predominantly managed by nursing staff, however it is true to state that all mental health disciplines find working with BPD challenging (Bland et al 2003, Bowers 2002, Cleary et al 2002, James & Cowman 2007, McVey & Murphy 2010).
Patients with BPD have frequently been excluded from services, possibly due to a lack of confidence and skills within the healthcare workforce (NICE 2009), where lack of and inadequate training is often cited as an issue for staff managing this difficult patient group (McVey & Murphy 2010). Current literature states that nursing staff do not feel the level of training is adequate in preparing them for the role of managing and treating BPD (Cleary et al 2002, Deans & Meocevic 2006, James & Cowman 2007, Krawitz 2004). Healthcare policy requires mental health services to become more responsive to the needs of patients with BPD (National Institute for Mental Health in England/Department of Health (NIMHE/DH) 2003) in an………………………………………………….
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