Consumer perspective from people with a diagnosis of Borderline Personality Disorder (BPD) on BPD management-How are the Australian NHMRC BPD guidelines faring in practice?
Jessica Margot Proctor, Sharon Lawn, Janne McMahon
PMID 33202081WHAT IT FOUND
People with BPD described delayed or poorly explained diagnoses, feeling dismissed during crisis, and continued barriers to specialist therapy.
Management plans were often imposed rather than co-authored, and some diagnosis communication problems were reported less often.
Key findings
01Consumers reported two main problems when being diagnosed: the diagnosis being withheld and poor explanations; in 2017, 50.69% felt the diagnosis was explained in a way they understood.
02Many consumers reported feeling dismissed, misunderstood, or not taken seriously by health professionals, especially during hospital admission and crisis situations.
03Management plans were rarely mentioned, and when mentioned respondents perceived them as harmful or imposed rather than collaboratively developed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were self-selected online survey respondents, not a random sample of people with BPD, so response bias may affect what was reported. The number of people invited is unknown, so an overall response rate cannot be determined. The surveys did not ask directly about knowledge or use of the NHMRC BPD Guidelines, so any change cannot be attributed to them. Responses were anonymous, so answers from the two survey rounds could not be matched to the same people. It was not known whether later respondents had received their diagnosis after the earlier survey or were recalling earlier experiences. Response rates varied by question, and only a small proportion answered all questions in the later survey. The analysis is qualitative and reports themes, not treatment effects.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read these survey themes as proof that the NHMRC Guidelines caused better care or that any specific treatment works. The surveys were not designed to test the Guidelines, participants were self-selected, and the analysis reports consumers' experiences rather than measured outcomes.