Thesis
Borderline Personality Disorder and Emotional Dysregulation in Crisis and Emergency Services in Australia: A Mixed Methods Exploration of Diagnostic and Decision-Making Processes of Mental Health Nurses
Southern Cross University
Doctor of Philosophy (PhD), Southern Cross University
2023
DOI:
https://doi.org/10.25918/thesis.507
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Abstract
Diagnosis is pivotal to enable access to evidence-based treatments within Australia’s healthcare system. Diagnosis has traditionally been the role of medical officers. However, mental health nurses (MHNs) in emergency and assessment settings within Australia must conduct assessments and provide a provisional diagnosis, often setting the future treatment trajectory. Although these MHNs are making provisional diagnoses of borderline personality disorder (BPD), there is no research that illuminates the factors influencing clinical and diagnostic decision-making for these nurses undertaking this critical role. This project aimed to gain insight into the attitudes, knowledge and confidence of MHNs in conferring and communicating a diagnosis of BPD in the context of the emergency department. Additionally, this thesis explored how MHNs make sense of presenting problems, what helpful interventions they provide, and how to mobilise this skilled component of the workforce best to ensure that people who present in crisis receive timely and effective ongoing care and treatment. A mixed methods approach was used in two phases with an existing survey tool and vignettes employed as the stimulus for semi-structured interviews. A survey of these nurses demonstrates that the attitudes towards BPD are changing, but the role and impact of these MHNs working within the emergency department is poorly defined and described. Regardless, these nurses are highly educated and skilled clinicians whose decision-making is constrained by complex contextual factors inhibiting their abilities to practise to their full potential and thus improve people’s experience. This study has significant implications because it highlights the uniqueness of the role and capability of these MHNs concerning their ability to provide a provisional diagnosis to assist in facilitating access to appropriate treatment despite some ambivalence about the validity, reliability and utility of diagnosis.
Details
- Title
- Borderline Personality Disorder and Emotional Dysregulation in Crisis and Emergency Services in Australia: A Mixed Methods Exploration of Diagnostic and Decision-Making Processes of Mental Health Nurses
- Creators
- Katrina Campbell
- Contributors
- Richard Lakeman (Supervisor) - Southern Cross UniversityDeb Louise Massey (Supervisor) - Southern Cross University
- Awarding Institution
- Southern Cross University; Doctor of Philosophy (PhD)
- Theses
- Doctor of Philosophy (PhD), Southern Cross University
- Publisher
- Southern Cross University
- Number of pages
- xvii, 373
- Identifiers
- 991013158713702368
- Copyright
- © Katrina Campbell 2023
- Academic Unit
- Faculty of Health
- Resource Type
- Thesis