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Int J Qual Stud Health Well-being. 2019 Dec;14(1):1667133. doi: 10.1080/17482631.2019.1667133.

Brief admission (BA) for patients with emotional instability and self-harm: nurses' perspectives - person-centred care in clinical practice.

Author information

1
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden.
2
Department of Health Sciences, The Swedish Red Cross University College , Stockholm , Sweden.
3
Northern Stockholm psychiatry,Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden.
4
School of Nursing, Hanze University of Applied Sciences , Groningen , The Netherlands.
5
The Department of Health Care Sciences, Ersta Sköndal Bräcke University College , Stockholm , Sweden.

Abstract

Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient's needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses' experiences working with BA related to patients with emotional instability and self-harm. Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis. Results: Four main categories emerged regarding nurses' experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient's health and empowers the patient. The nurse's role shifted from "handling problems" to establishing caring relationships with a focus on the person's health and possibilities for recovering instead of psychiatric symptoms. Conclusions: Previous studies on patients' perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care.

KEYWORDS:

Borderline personality disorder; brief admission; crisis intervention; emotional instability; mental health nursing; patient admission; person-centred care; psychiatric nursing; self-harm

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