Exploring therapeutic engagement with individuals with a diagnosis of personality disorder in acute psychiatric inpatient settings: A nursing team perspective

Int J Ment Health Nurs. 2019 Oct;28(5):1173-1182. doi: 10.1111/inm.12629. Epub 2019 Jul 8.

Abstract

Individuals with a diagnosis of personality disorder (PD) face negative attitudes and are often deemed harder to care for than individuals with other diagnoses. To improve care and engagement with services, it is essential to understand the ways general psychiatric nursing staff approach this client group. This research aims to examine the ways inpatient psychiatric nursing staff therapeutically engage with individuals with a diagnosis of PD. Focus groups were conducted with Registered Mental Health Nurses (n = 7) and Health Care Assistants (formally known as nursing assistants; n = 12) who care for individuals with a diagnosis of PD in a general psychiatric inpatient setting. A thematic analysis indicated six themes: the right frame of mind, knowing the service user, knowing when to engage, service user input, a unified approach, and structured admissions. The findings highlight what non-PD specialist inpatient nursing staff do in order to engage therapeutically with this group of service users and areas that require improvement. Supporting good practice could improve staff confidence when caring for this client group, lower stigma around the diagnosis, and promote a more positive experience of care for individuals with a diagnosis of PD who are using general inpatient mental health services.

Keywords: nursing; personality disorder; psychiatric inpatient care; thematic analysis; therapeutic engagement.

MeSH terms

  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Nurse-Patient Relations*
  • Patient Participation / psychology*
  • Personality Disorders / psychology
  • Personality Disorders / therapy*
  • Psychiatric Nursing*
  • Surveys and Questionnaires