Nurses' experiences on the use of Positive Behaviour Support in the management of challenging behaviour in adults with a dual diagnosis of a mental health disorder and an intellectual disability

Abstract

Introduction

Individuals who have a dual diagnosis of both a psychiatric disorder and an intellectual disability (ID) are more likely to exhibit challenging behaviour than the general population. Clinicians globally have been encouraged to use positive approaches such as Positive Behaviour Support (PBS) when managing challenging behaviour.

Aim

To explore nurses' views, opinions and perceptions on the use of positive behaviour support, as an adjunctive therapy, in the management of challenging behaviour in adults with a dual diagnosis of a mental health disorder and an intellectual disability within a mental health setting.

Method

A descriptive qualitative study was undertaken to identify registered nurses' experiences of using PBS in managing challenging behaviour. Data were collected from ten participants via semi-structured interviews and analysed using thematic analysis.

Results

Two themes were constructed; 1) Being involved from the beginning and 2) Impact on adults with a dual diagnosis.

Discussion

Nurses' involvement from the onset was fundamental in maximising the potential of PBS. Benefits of PBS were identified. Having a meaningful relationship with clients and a good knowledge of their behaviours was integral to the success of PBS.

Implications for practice

Participants emphasised the importance of continuous education around PBS. Nurses should be included in the formulation of PBS plans.

What are the implications for practice?

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  Nurses identified the need for continuous education around PBS, highlighting the potential benefits of practical workshops, where nurses could be afforded an opportunity to enhance their PBS skills.

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  Nurses held the belief that their inclusion in PBS formulation from the outset was imperative to help aid the success of the intervention.

Relevance statement

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  This paper focuses on the views of nurses on the use of PBS in the management of challenging behaviour, in adults with a dual diagnosis of a mental health disorder and an intellectual disability. There has been an international focus on reducing restrictive practices in the management of challenging behaviours. Consequently, there is an increased use of PBS. It is important nurses use PBS from the onset to ensure the consistent management of challenging behaviours. Having a good rapport and relationship with clients has a positive impact on PBS outcomes.