Experiences of patients with borderline personality disorder with the crisis intervention “Brief Admission ” A Qualitative analysis. M. Helleman Rn MScN T. van Achterberg Rn PhD FEANS P.J.J. Goossens Rn PhD APRN FEANS A. Kaasenbrood, MD, PhD.
Experiences ofpatientswith borderline personality disorder with the crisis intervention “Brief Admission” A Qualitative analysis
M. Helleman Rn MScN
T. van Achterberg Rn PhD FEANS
P.J.J. Goossens Rn PhD APRN FEANS
A. Kaasenbrood, MD, PhD
A frequently used crisis-intervention is a "Brief Admission".
This is not an evidence based intervention.
Even in my organisation there are different protocols for every ward.
During my PhD study, an evidence base for this intervention will be build.
Knowledge about the experience of patients is an important building block for the development of this intervention.
Records identified via search of titles in database (n =1059)
Additional records identified via other sources (n = 2)
Records left after duplicates removed (n =1030)
Records excluded(n =942) on basis of title
Records screened on abstract (n = 88)
Abstracts excluded (n = 64) , not about BPD, lacking a description of BA
Full-text of articles examined for eligibility (n =24)
Articles excluded (n=14), not about BPD or lacking a description of BA
Studies included in qualitative synthesis (n = 10)
Five key components of Brief Admission as an intervention could be identified:
discussion of goals;
organization of Brief Admission;
clear admission procedure;
specification of any other interventions during Brief Admission;
stipulation of conditions for premature discharge.
The aim of this study is to describe the lived experience of patients with borderline personality disorder with the intervention Brief Admission.
A phenomenological approach was used
A convience sample of 17 outpatients
Data were gathered through open qualitative in-depth interviews.
Data-analyse was proceeded using the steps of Giorgi (1997, 2008).
16 female’s, one male
Mean age 43,8 years old
Diagnosted with BPD
Experience with BA > one year
Reasons for asking for a Brief Admission
“For me, when the pressure in my daily live gets to high, to much stress, to much at te same time, I can call them. To come and try to relax again”
“When I have thoughts about auto mutilation, I feel there more save. There are less posibilities and there is someone to talk with”
“I made the Brief Admission Treatment plan with my community nurse and the nurse of the clinic”
“Discuss with a patient what the expectations of the BA are. What is the goal? Put this on paper, individualy. What to expect from the clinic? Lets this be clear”
“The nurses think about things I cannot think of myself at such moments. What I can do to find distraction, par example”.
Daring to contact the nurse
“I am often not so clear when I ask for help. To find the words is hard in a crisis situation. I haven’t slept for days and my head just doesn’t work that well. My logic is gone”.
“If there is a nurse I know and trust, I dare to go and ask for a talk. I avoid the others”.
“When I arrived I have a conversation with the nurse. What do you need? What can I do for you? With whom will the conversations be? So that’s all clear to me”.
‘Can’t say the whole crisis was over, but I came home more relaxed and was able to work again”.
‘If I can’t talk to someone, it has no use. I rather stay at home, then”.
Brief Admission is a welcome escape from crisis and can work preventively.
A clear plan with goals is crucial for patients.
During their crisis it’s hard for patient to be responsible for initiating conversations with the nurses.
Conversations with the nurses are essential to reduce tension.