The attitudes of mental health nurses that support a positive therapeutic relationship: The perspective of people diagnosed with BPD
Authors: Romeu‐Labayen Maria , Tort‐Nasarre Glòria , Rigol Cuadra M. Assumpta , Giralt Palou Rosa , Galbany‐Estragués Paola 
Published: May 2021

Accessible Summary

What is known on the subject?

Some nurses develop positive relationships with people diagnosed with borderline personality disorder (BPD), while others have negative emotional reactions to people diagnosed with this disorder.

The therapeutic relationship is key in the practice of mental health nursing.

Enhanced knowledge of BPD allows mental health nurses to develop improved self‐awareness, knowledge and understanding of the individuals and insight into the therapeutic challenges, which can improve attitudes towards people with this diagnosis.

What the paper adds to existing knowledge?

We are lacking knowledge about the perspective of people diagnosed with BPD on the attitudes of mental health nurses that facilitate a positive therapeutic relationship.

The perspective of people with a BPD diagnosis on the therapeutic relationship offers key information about the attitudes that they credit with supporting their recovery.

The participants—people diagnosed with BPD—perceived that the following attitudes of mental health nurses reinforced the therapeutic relationship: confidence in the person's recovery, non‐judgement, sense of humour, availability and humanity.

What are the implications for practice?

The study highlights mental health nurses’ attitudes that participants perceived as having a positive effect on the therapeutic relationship.

The recognition among people diagnosed with BPD of the constructive attitudes of mental health nurses may improve nurses’ motivation to improve care for these patients.

This study will allow mental health nurses to increase their awareness of the importance of attitude in the therapeutic relationship with people diagnosed with BPD.

Introduction

The therapeutic relationship between mental health nurses and people diagnosed with borderline personality disorder (BPD) is essential to successful treatment, and nurses’ attitudes are a key component of this relationship. Some nurses develop positive therapeutic relationships with people diagnosed with BPD, while others have negative emotional reactions which in turn limit their ability to develop a positive therapeutic relationship. There is a gap in the literature with respect to how people diagnosed with BPD perceive the attitudes of mental health nurses that foster a positive therapeutic relationship.

Aim

To describe how people diagnosed with BPD who have experienced an improvement perceive the role of the attitudes of mental health nurses in building a positive therapeutic relationship.

Method

Qualitative descriptive design with 12 interviews; thematic content analysis.

Results

Participants identified five attitudes of mental health nurses as contributing to a positive therapeutic relationship: confidence in their ability to recover, non‐judgement, humour, availability and humanity.

Discussion

Nurses’ attitudes are key to the therapeutic relationship. It may be possible for nurses to improve their attitudes towards patients diagnosed with BPD through self‐reflection.

Implications for practice

Mental health nurses should incorporate methods that explore attitudes and attitudinal development of the workforce.