Abstract
The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.
Highlights
Borderline personality disorder (BPD) presents various signs in interpersonal relationships, self-image, and emotions such as instability and impulsivity
A single interview was conducted with each nurse (n = 16) who had an experience of interacting with families of borderline personality disorder (BPD) patients in their nursing practice
16 nursing professionals having experience in caring for families with a BPD patient were the subjects of semi-structured interviews, thereby clarifying the family support process being provided to such family members
Summary
Borderline personality disorder (BPD) presents various signs in interpersonal relationships, self-image, and emotions such as instability and impulsivity. It usually appears in early adulthood and is diagnosed in various circumstances [1]. In order to be diagnosed with BPD, at least five of the nine criteria must be present: 1) frantic efforts to avoid real or imagined abandonment; 2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation; 3) identity disturbance: markedly and persistently unstable self-image or sense of self; 4) impulsivity in at least two areas that are potentially self-damaging; 5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior; 6) affective instability due to a marked reactivity of mood; 7) chronic feelings of emptiness; 8) inappropriate, intense anger or difficulty controlling anger and 9) transient, stress-related paranoid ideation or severe dissociative symptoms. Other types of negative behavior take the forms of overspending or sexual aberrations
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