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Brief admission for patients with emotional instability and self-harm: A qualitative analysis of patients' experiences during crisis
The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.ORCID iD: 0000-0001-8468-6457
Karolinska Institutet.ORCID iD: 0000-0003-2680-0340
Karolinska Institutet / Northern Stockholm Psychiatry.ORCID iD: 0000-0001-9719-3045
Karolinska Institutet.ORCID iD: 0000-0002-2678-3782
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2020 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349Article in journal (Refereed) Epub ahead of print
Abstract [en]

Previous studies report that individuals diagnosed with borderline personality disorder have been met by negative attitudes from healthcare professionals and their care needs have often been neglected during hospitalizations. When symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult to handle for patients and healthcare professionals. To meet their care needs during these crises, an intervention called 'brief admission' (BA) has been developed. The purpose of BA is to provide a timeout, in situations of increased stress and threat, in order to foster self-management in a safe environment. In the present study, we explored the following research questions: What are patients' experiences with BA? What do patients consider to be the key components of BA? What improvements are considered relevant by patients? A qualitative design was employed, and 15 patients (13 females, 2 males; mean age 38.5 ± 12.9, range 20-67 years) were interviewed using a semi-structured interview guide. Thematic analyses were performed, which yielded four themes related to the patients' experiences: 'a timeout when life is tough', 'it is comforting to know that help exists', 'encouraged to take personal responsibility', and 'it is helpful to see the problems from a different perspective'. Four themes also described the key components: 'a clear treatment plan', 'a smooth admission procedure', 'a friendly and welcoming approach from the staff', and 'daily conversations'. Lastly, three themes described areas for improvements: 'feeling guilty about seeking BA', 'room occupancy issues', and 'differences in staff's competence'. Collectively, the findings indicate that BA constructively supports patients with emotional instability and self-harm during a period of crisis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020.
Keywords [en]
borderline personality disorder, crisis intervention, patient admission, psychiatric nursing, self-injurious behaviour
National Category
Nursing
Identifiers
URN: urn:nbn:se:rkh:diva-3408DOI: 10.1111/inm.12736PubMedID: 32406168OAI: oai:DiVA.org:rkh-3408DiVA, id: diva2:1431066
Available from: 2020-05-19 Created: 2020-05-19 Last updated: 2020-05-29Bibliographically approved

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Perseius, Kent-Inge

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Eckerström, JoachimFlyckt, LenaCarlborg, AndreasJayaram-Lindström, NityaPerseius, Kent-Inge
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