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Experiences of a peer group for people diagnosed with borderline personality disorder: A qualitative interview study. 被诊断患有边缘型人格障碍的人参加同伴小组的经历:定性访谈研究。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2024-02-04 DOI: 10.1002/pmh.1604
Sophie C Dahlenburg, Dianna R Bartsch, Jessica A Giles, Kristy A Koehne, Judy O'Sullivan

There is a notable lack of literature evaluating peer support for people with a diagnosis of borderline personality disorder (BPD). Peer-led groups have been shown to positively impact outcomes related to empowerment, hope, and self-efficacy beliefs for consumers diagnosed with serious mental illness and may also be a helpful option for those experiencing personality disorder symptoms. We outline the coproduction of a peer group for people with a lived experience of BPD and a qualitative analysis of feedback post-group participation. Twenty-two consumers participated in post-group interviews and described their experiences of peer support. Interview transcripts were coded, and three main themes were identified: growth and change, connection and feeling understood, and creating safety. The findings suggested that participation in a coproduced peer support group for people with a diagnosis of BPD facilitated positive personal transformation as well as opportunities to develop connection through shared experiences in a safe environment grounded in mutuality. These themes were particularly powerful for participants because they countered previous experiences of not feeling safe, understood, or equal when seeking treatment. These findings support the acceptability of implementing a coproduced group for people diagnosed with BPD in a community mental health setting.

目前明显缺乏对边缘型人格障碍(BPD)患者的同伴支持进行评估的文献。对于被诊断患有严重精神疾病的人来说,由同伴引导的小组已被证明对与赋权、希望和自我效能信念相关的结果产生了积极影响,对于那些有人格障碍症状的人来说,这可能也是一种有益的选择。我们概述了为有 BPD 生活经历的人共同创建同伴小组的情况,以及对参加小组后的反馈进行的定性分析。22 名参与者参与了小组活动后的访谈,并描述了他们在同伴互助中的经历。对访谈记录进行了编码,确定了三大主题:成长与改变、联系与被理解感以及创造安全感。研究结果表明,参与为被诊断出患有 BPD 的人共同创建的同伴互助小组促进了积极的个人转变,以及通过在一个以相互性为基础的安全环境中分享经验来发展联系的机会。这些主题对参与者来说尤为重要,因为它们消除了他们以前在寻求治疗时感到不安全、不被理解或不平等的经历。这些研究结果支持了在社区心理健康环境中为被诊断患有 BPD 的人实施共同小组的可接受性。
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引用次数: 0
Longitudinal examination of borderline personality disorder symptoms and drug use: The influence of negative and positive emotion dysregulation. 边缘型人格障碍症状与药物使用的纵向研究:消极和积极情绪失调的影响。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2024-02-20 DOI: 10.1002/pmh.1602
Elinor E Waite, Alexa M Raudales, Noam G Newberger, Jewelia J Ferguson, Dominic M Denning, Sarah Huffman, Nicole H Weiss, Katherine L Dixon-Gordon

Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1 year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.

边缘型人格障碍(BPD)与更多的药物使用有关。情绪失调与边缘型人格障碍和药物使用都有关系,但有关情绪失调在边缘型人格障碍与药物使用关系中的作用的研究却很有限。我们研究了 BPD 症状和情绪失调在报告的一年药物使用中的独立和交互关联。参与者(N = 143)被过度招募为 BPD 患者,通过访谈进行评估,并完成了消极和积极情绪失调的测量。在为期一年的时间里,通过每月调查对吸毒频率进行评估。结果表明,BPD 症状与消极和积极情绪失调之间存在相互关系。然而,当把 BPD 和情绪失调一起建模时,只有较高的 BPD 症状才与更频繁的吸毒有关。研究结果支持BPD症状与情绪失调之间的关系,但表明在社区招募的人群中,情绪失调可能并不是导致吸毒频率高于BPD的原因。
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引用次数: 0
Replicability of the five-factor structure of DSM-5 and ICD-11 trait systems and their associations with binge eating and bipolar spectrum psychopathology. DSM-5和ICD-11特征系统五因素结构的可复制性及其与暴饮暴食和双相情感障碍精神病理的关系
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2023-11-29 DOI: 10.1002/pmh.1600
Anis Vaysi, Parisa Nazarpour, Zhaleh Kiani, Mahtab Maleki, Maryam Hamzehei, Federico Amianto, Martin Sellbom, Saeid Komasi

Since the research on contemporary personality models-and psychopathology-mainly originate from the Western world, we aimed to test the factorial structure of two trait systems assessed with the Personality Inventory for DSM-5 (PID-5) in a non-Western sample and to compare the extracted models' relative associations with binge eating disorder (BED) and bipolar spectrum disorder (BSD) symptoms. A community sample (N = 516; 72% female) was administered the PID-5, which can operationalize both the DSM-5 and ICD-11 systems. The factor structures of both systems were tested using exploratory structural equation modeling (ESEM). The congruence coefficients of all factor loadings with international studies were calculated. The Binge Eating Scale (BES), Bipolar Spectrum Diagnostic Scale (BSDS), and Hypomania Checklist-32-Revised (HCL-32) were used to measure the criterion variables. Linear regression models were used for comparing the DSM-5 and ICD-11 systems in predicting the BED and BSD. The findings supported five-factor solutions for both trait systems. Both systems significantly predicted dimensional measures of both BED and BSD (all p < 0.001). The present findings support an acceptable five-factor structure for both personality systems in the non-Western sample. Different algorithms of maladaptive domains on both systems are related to binge eating and bipolar spectrum psychopathology.

由于当代人格模型和精神病理学的研究主要起源于西方世界,我们的目的是在非西方样本中测试用DSM-5人格量表(PID-5)评估的两种特征系统的析因结构,并比较提取的模型与暴食症(BED)和双相谱系障碍(BSD)症状的相对关联。社区样本(N = 516;(72%女性)进行PID-5,它可以使DSM-5和ICD-11系统同时运作。采用探索性结构方程模型(ESEM)对两个系统的因子结构进行检验。计算所有因子负荷与国际研究的同余系数。采用暴食量表(BES)、双相情感障碍诊断量表(BSDS)和轻躁狂量表-32-修订版(HCL-32)测量标准变量。采用线性回归模型比较DSM-5和ICD-11系统对BED和BSD的预测。研究结果支持这两种性状系统的五因素解决方案。两种系统都能显著预测BED和BSD的尺寸测量(均为p
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引用次数: 0
Impact of clinical severity on treatment response in a randomized controlled trial comparing day hospital and intensive outpatient mentalization-based treatment for borderline personality disorder. 在一项随机对照试验中,比较日间医院和门诊强化精神治疗对边缘型人格障碍的治疗反应,临床严重程度对治疗反应的影响。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2024-01-31 DOI: 10.1002/pmh.1603
Maaike L Smits, Dine J Feenstra, Matthijs Blankers, Jan H Kamphuis, Dawn L Bales, Jack J M Dekker, Roel Verheul, Jan J V Busschbach, Patrick Luyten

This study examined the impact of clinical severity on treatment outcome in two programs that differ markedly in treatment intensity: day hospital mentalization-based treatment (MBT-DH) and intensive outpatient mentalization-based treatment (MBT-IOP) for borderline personality disorder (BPD). A multicenter randomized controlled trial was conducted. Participants include the full intention-to-treat sample of the original trial of N = 114 randomized BPD patients (MBT-DH n = 70, MBT-IOP n = 44), who were assessed at baseline and subsequently every 6 up to 36 months after start of treatment. Outcomes were general symptom severity, borderline features, and interpersonal functioning. Clinical severity was examined in terms of severity of BPD, general symptom severity, comorbid symptom disorders, comorbid personality disorders, and cluster C personality features. None of the severity measures was related to treatment outcome or differentially predicted treatment outcome in MBT-DH and MBT-IOP, with the exception of a single moderating effect of co morbid symptom disorders on outcome in terms of BPD features, indicating less improvement in MBT-DH for patients with more symptom disorders. Overall, patients with varying levels of clinical severity benefited equally from MBT-DH and MBT-IOP, indicating that clinical severity may not be a useful criterion to differentiate in treatment intensity.

本研究探讨了临床严重程度对两个治疗方案的治疗结果的影响,这两个方案的治疗强度存在明显差异:日间医院精神治疗(MBT-DH)和门诊精神强化治疗(MBT-IOP)用于治疗边缘型人格障碍(BPD)。我们开展了一项多中心随机对照试验。参与者包括原始试验的全部意向治疗样本,即 114 名随机 BPD 患者(MBT-DH 70 人,MBT-IOP 44 人),他们在基线时接受评估,随后在治疗开始后每 6 个月至 36 个月接受一次评估。评估结果包括一般症状严重程度、边缘性特征和人际功能。临床严重程度从 BPD 严重程度、一般症状严重程度、合并症状障碍、合并人格障碍和 C 群人格特征等方面进行考察。在 MBT-DH 和 MBT-IOP 中,没有一项严重程度测量与治疗结果有关,或对治疗结果有不同的预测作用,只有在 BPD 特征方面,共病症状障碍对治疗结果有单一的调节作用,表明症状障碍较多的患者在 MBT-DH 中的改善程度较低。总体而言,临床严重程度不同的患者同样受益于 MBT-DH 和 MBT-IOP,这表明临床严重程度可能不是区分治疗强度的有用标准。
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引用次数: 0
Antisocial personality traits relationship with behaviours and beliefs on COVID-19 containment measures: Investigation in a large Brazilian sample. 反社会人格特质与 COVID-19 遏制措施中的行为和信念之间的关系:巴西大样本调查。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2023-12-27 DOI: 10.1002/pmh.1601
Lucas de Francisco Carvalho, Fabiano Koich Miguel, Gisele Magarotto Machado, Cibelle de Oliveira, Giselle Pianowski

In the COVID-19 context, traits associated with antisociality can decrease concern and awareness about the potential harmfulness of the virus. This study investigated associations of pathological traits of antisocial personality disorder (ASPD) with behaviours and beliefs linked to COVID-19 containment measures. The sample consisted of 2230 Brazilian adults who answered ASPD-related facets of the Personality Inventory for DSM-5 and a questionnaire regarding adherence to COVID-19 containment measures. We applied the DSM-5 ASPD criteria to divide the sample into antisocial and non-antisocial groups. Our findings suggest that individuals meeting the criteria for ASPD tend to exhibit reduced compliance with pandemic control measures and lower adherence to hygiene practices. Moreover, sex, income, and age should be considered potential covariates in research investigating the relationship between antisocial traits and adherence to COVID-19 preventive measures. Altogether, our findings highlight ASPD traits' role in the predisposition to lack of prosocial behaviours of adherence to COVID-19 containment measures.

在 COVID-19 的背景下,与反社会性相关的特征可能会降低人们对病毒潜在危害性的关注和认识。本研究调查了反社会人格障碍(ASPD)的病理特征与 COVID-19 抑制措施相关的行为和信念之间的联系。样本由 2230 名巴西成年人组成,他们回答了 DSM-5 人格量表中与反社会人格障碍相关的部分,并回答了有关 COVID-19 抑制措施遵守情况的问卷。我们采用 DSM-5 ASPD 标准将样本分为反社会和非反社会两组。我们的研究结果表明,符合 ASPD 标准的人往往会降低对流行病控制措施的依从性,并降低对卫生习惯的依从性。此外,在调查反社会特质与遵守 COVID-19 预防措施之间关系的研究中,应将性别、收入和年龄视为潜在的协变量。总之,我们的研究结果凸显了反社会人格特质在缺乏亲社会行为、不遵守 COVID-19 预防措施方面的易感性。
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引用次数: 0
Mediators of change in psychological interventions for adult offenders with personality disorders: A scoping review of the literature. 对有人格障碍的成年罪犯进行心理干预的变化媒介:文献综述。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2024-03-01 DOI: 10.1002/pmh.1606
Roxanna Short, Darrick Jolliffe, Ben Carter, Colin Campbell

Offenders with personality disorder cause disproportionate harm to society and pose significant challenges for those responsible for their care and rehabilitation. Personality disorders are heterogeneous in terms of symptoms, as well as their pathways to offending behaviour. Thus, there is limited evidence regarding effective interventions. One solution might be to focus on how interventions are delivered as well as what is delivered. Within the non-offender personality disorder literature, the identification of potential mediators of change has enabled interventions to focus on 'how' they are delivered (e.g., therapeutic alliance) rather than the intervention itself. We explore the evidence and present a scoping review of the available literature on the mechanisms of change in psychological treatments for offenders with personality disorder. Only one study was found in the scoping review, highlighting a significant gap in the evidence base. We discuss the implications of this finding and potential future directions.

患有人格障碍的罪犯对社会造成了极大的伤害,并给负责照顾他们和帮助他们康复的人员带来了巨大的挑战。人格障碍的症状及其导致犯罪行为的途径各不相同。因此,有关有效干预措施的证据十分有限。解决方法之一可能是关注干预的方式和内容。在非罪犯人格障碍的文献中,对改变的潜在中介因素的识别使干预措施能够关注 "如何 "实施(如治疗联盟),而不是干预措施本身。我们探讨了相关证据,并就人格障碍罪犯心理治疗的改变机制对现有文献进行了范围界定。在范围审查中只发现了一项研究,凸显了证据基础中的重大空白。我们讨论了这一发现的影响以及未来可能的发展方向。
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引用次数: 0
Diagnosing borderline personality disorder: Reports and recommendations from people with lived experience. 诊断边缘型人格障碍:有生活经验的人的报告和建议。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-05-01 Epub Date: 2023-11-23 DOI: 10.1002/pmh.1599
Vanessa Tedesco, Nicholas John Stephen Day, Sophie Lucas, Brin F S Grenyer

Borderline personality disorder (BPD) is a severe mental health condition marked by impairments in self and interpersonal functioning. Stigma from health staff may often result in a reluctance to diagnose, impacting recovery trajectories. Qualitative interviews were conducted with participants (N = 15; M Age = 36.4 years, SD = 7.5; 93.3% female) with lived experience of BPD exploring topics of illness onset, insight, experience of diagnosis and treatment. Qualitative responses were analysed within a co-design framework with a member of the research team who identifies as having a lived experience of BPD. On average, participant symptoms emerged at 12.1 years of age (SD = 6.6 years, range 1.5-27), but diagnoses of BPD were delayed until 30.2 years (SD = 7.8 years, range 18-44) resulting in a 'diagnosis gap' of 18.1 years (SD = 9.6 years, range 3-30). Participant explanations for BPD emergence varied from biological, psychological and social factors. Benefits of diagnosis (e.g., fostering insight, aiding treatment planning and reducing isolation) were contrasted with challenges (e.g., stigma and treatment unavailability). Delay in diagnosis was common, and no participants reported receiving a diagnosis of BPD during their adolescence yet 85% felt they would have benefited from a diagnosis in adolescence. Only a quarter (27%) felt highly supported in the diagnostic process. An ideal four-step diagnosis procedure was outlined based on recommendations from participants with a lived experience; this involved the following: (1) explain the process, (2) assess thoroughly, (3) explore how the features are active in everyday life and (4) link diagnosis to evidence-based treatment planning.

边缘型人格障碍(BPD)是一种以自我和人际功能障碍为特征的严重精神健康状况。卫生工作人员的耻辱感往往会导致不愿诊断,从而影响康复轨迹。对参与者进行定性访谈(N = 15;年龄= 36.4岁,SD = 7.5;(93.3%为女性),有BPD生活经历,探讨发病、洞察力、诊断和治疗经验。在一个共同设计框架内,研究小组的一名成员对定性反应进行了分析,该成员认为自己有过BPD的生活经历。平均而言,参与者在12.1岁时出现症状(SD = 6.6岁,范围1.5-27),但BPD的诊断延迟到30.2岁(SD = 7.8岁,范围18-44),导致“诊断差距”为18.1岁(SD = 9.6岁,范围3-30)。参与者对BPD出现的解释有生物、心理和社会因素。诊断的好处(例如,培养洞察力,帮助治疗计划和减少孤立)与挑战(例如,耻辱和无法获得治疗)进行了对比。延迟诊断是很常见的,没有参与者报告在青春期被诊断为BPD,但85%的人认为他们会从青春期的诊断中受益。只有四分之一(27%)的人在诊断过程中得到了高度支持。一个理想的四步诊断程序概述了基于参与者的建议与生活经验;这包括以下内容:(1)解释过程;(2)彻底评估;(3)探索这些特征在日常生活中是如何活跃的;(4)将诊断与循证治疗计划联系起来。
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引用次数: 0
Loneliness in narcissistic vulnerability: Examining domains of personality functioning. 自恋脆弱者的孤独感:研究人格功能的各个领域。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-04-26 DOI: 10.1002/pmh.1615
Ellen F Finch, D. Kealy
Research has indicated loneliness to be a detrimental correlate of narcissistic vulnerability. However, no research has examined if this relationship persists across time or why it occurs. The present study explores the link between narcissistic vulnerability and loneliness across time and examines which domains of personality dysfunction (i.e., identity, self-direction, empathy, and intimacy) may account for why narcissistic vulnerability is related to loneliness. Adult participants (N = 298) were recruited from Prolific and completed study questionnaires assessing narcissistic vulnerability, narcissistic grandiosity, loneliness, domains of self and interpersonal functioning, and neuroticism. Two months later, participants repeated the measure of loneliness. Correlations among all study variables were calculated, followed by linear regression analyses to investigate how personality functioning domains may mediate the longitudinal relationship between narcissistic vulnerability and loneliness. The effects of baseline loneliness, relationship status, and trait neuroticism were controlled for. Narcissistic vulnerability, but not narcissistic grandiosity, was associated with loneliness at baseline and 2 months later. Intimacy functioning, but not identity, self-direction, or empathy functioning, was a significant mediator of the relationship between narcissistic vulnerability and loneliness over time. These findings suggest that narcissistic vulnerability may contribute to the development or maintenance of loneliness across time, highlighting the role of impaired intimacy functioning in this relationship. The impact of these findings on our understanding of interpersonal functioning in narcissistic vulnerability, as well as clinical implications, is discussed.
研究表明,孤独是自恋脆弱性的一个不利相关因素。然而,目前还没有研究探讨这种关系是否会随着时间的推移而持续,或者为什么会出现这种关系。本研究探讨了自恋脆弱性与孤独感在不同时期的联系,并研究了人格功能障碍的哪些领域(即身份、自我导向、移情和亲密关系)可能是自恋脆弱性与孤独感相关的原因。研究人员从 Prolific 公司招募了成年参与者(N = 298),并完成了评估自恋脆弱性、自恋自大、孤独感、自我和人际功能领域以及神经质的研究问卷。两个月后,参与者再次进行了孤独感测量。我们计算了所有研究变量之间的相关性,然后进行了线性回归分析,以研究人格功能域是如何调解自恋脆弱性与孤独感之间的纵向关系的。基线孤独感、人际关系状况和特质神经质的影响已被控制。自恋的脆弱性与基线和两个月后的孤独感相关,但自恋的自大狂与孤独感无关。随着时间的推移,亲密关系功能(而非身份认同、自我导向或移情功能)是自恋脆弱性与孤独感之间关系的重要中介。这些研究结果表明,自恋的脆弱性可能会导致孤独感的发展或维持,并突出了亲密关系功能受损在这种关系中的作用。本文讨论了这些发现对我们理解自恋脆弱性中人际功能的影响以及临床意义。
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引用次数: 0
Long-lasting symptoms in borderline personality disorder: Defining an emergent population with differential clinical and therapeutic features. 边缘型人格障碍的长期症状:界定具有不同临床和治疗特征的新兴人群。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-04-26 DOI: 10.1002/pmh.1614
Elisabet Casellas-Pujol, Joaquim Soler, Carlos Schmidt, Jose Soriano, Juan C. Pascual
Although the clinical symptoms of borderline personality disorder (BPD) tend to remit over time, a substantial proportion continues to present "long-lasting symptoms" (LLS). This term refers to individuals who present some degree of clinical improvement, but low mood, feelings of emptiness, and poor psychosocial adjustment typically persist. The aim of this study was to compare the sociodemographic, clinical, and therapeutic variables in individuals with BPD with and without LLS. A total of 620 participants with BPD were included and subdivided into two groups: non-LLS group (n = 549, mean age = 28.02 [6.1] and range, 18-40 years) and LLS group (n = 71, mean age = 44.69 [3.6] and range, 41-56 years). The groups were compared in sociodemographic, clinical, and drug treatment characteristics. We also evaluated the impact of dialectical behavioral therapy-skills training (DBT-ST) on polypharmacy. The prevalence of individuals with long-lasting BPD symptoms increased significantly over a 20-year period (from <1% to 16%). The LLS group was characterized by less clinical severity, higher comorbidity with affective disorders but lower comorbidity with eating disorders, more disability, and more medication taking. Patients with LLS who received DBT-ST experienced a significant decrease in the use of benzodiazepines and the number of medications prescribed compared with those who did not receive DBT-ST. Clinicians should be aware of the specific features of older patients with BPD in order to better identify and address their specific therapeutic needs.
尽管边缘型人格障碍(BPD)的临床症状往往会随着时间的推移而缓解,但仍有相当一部分患者会持续出现 "持久症状"(LLS)。所谓 "持久症状",是指患者的临床症状有一定程度的改善,但情绪低落、空虚感和不良的社会心理适应能力依然存在。本研究的目的是比较有 LLS 和无 LLS 的 BPD 患者的社会人口学、临床和治疗变量。研究共纳入了 620 名 BPD 患者,并将其分为两组:非 LLS 组(n = 549,平均年龄 = 28.02 [6.1],年龄范围为 18-40 岁)和 LLS 组(n = 71,平均年龄 = 44.69 [3.6],年龄范围为 41-56 岁)。两组在社会人口学、临床和药物治疗特征方面进行了比较。我们还评估了辩证行为疗法-技能培训(DBT-ST)对多重药物治疗的影响。在 20 年的时间里,长期 BPD 症状患者的患病率显著增加(从 <1% 增加到 16%)。LLS 组的特点是临床严重程度较低、与情感障碍的合并率较高,但与进食障碍的合并率较低、残疾程度较高、服药次数较多。与未接受 DBT-ST 治疗的患者相比,接受 DBT-ST 治疗的 LLS 患者使用苯二氮卓类药物和处方药的数量显著减少。临床医生应该了解老年 BPD 患者的具体特征,以便更好地识别和满足他们的特殊治疗需求。
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引用次数: 0
Implementing a whole-of-service stepped care approach to personality disorder treatment: Impact of training and service redesign on clinician attitudes and skills 在人格障碍治疗中实施整体服务阶梯式护理方法:培训和服务重新设计对临床医生态度和技能的影响
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2024-03-19 DOI: 10.1002/pmh.1612
Brin F. S. Grenyer, Rachel C. Bailey
Personality disorders are a highly prevalent mental health condition. Historically, clinician attitudes have been negative, and only a small number have specialised training. This study evaluated clinician attitudes and confidence in working with people with personality disorder following the combination of training and implementation of a stepped care whole-of-service approach. A total of 102 multidisciplinary mental health clinicians were trained to implement the stepped care approach, and completed surveys prior to implementation and at 12 months follow up. Clinicians delivered manualised structured psychological therapy as part of the model. Measures assessed changes in attitudes and confidence, and impact of the service changes and therapy approach. Qualitative responses elucidated core themes. Evaluation at 12 months post training and service redesign showed improvements in clinician skills, confidence, theoretical knowledge and attitudes. Qualitative thematic analysis found core themes of improved understanding, clinical skills and improvements in the accessibility and timeliness of treatment. Implementing a whole-of-service model featuring stepped care therapies enhanced clinician attitudes, confidence, skills and knowledge in working with people with personality disorders. Clinicians identified that the whole-of-service model also improved accessibility to treatment, and quality of clinical care to the consumer and their carers.
人格障碍是一种高发的精神疾病。一直以来,临床医生的态度都很消极,只有少数人接受过专业培训。本研究评估了临床医生在接受培训并实施阶梯式整体服务方法后,对人格障碍患者的工作态度和信心。共有 102 名多学科精神卫生临床医生接受了实施阶梯式护理方法的培训,并在实施前和 12 个月的随访中完成了问卷调查。作为该模式的一部分,临床医生提供了手动结构化心理治疗。调查评估了态度和信心的变化,以及服务变化和治疗方法的影响。定性回答阐明了核心主题。培训和服务重新设计后 12 个月的评估显示,临床医生的技能、信心、理论知识和态度都有所改善。定性主题分析发现,核心主题是提高理解能力、临床技能以及治疗的可及性和及时性。实施以阶梯式护理疗法为特色的整体服务模式增强了临床医生在与人格障碍患者合作时的态度、信心、技能和知识。临床医生认为,整体服务模式还改善了治疗的可及性,提高了对患者及其护理者的临床护理质量。
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引用次数: 0
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Personality and Mental Health
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