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Need of support for significant others to persons with borderline personality disorder: A Swedish focus groupstudy
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Nyckeln Competence Center, Kalmar County Hospital, Kalmar, Sweden.ORCID iD: 0000-0002-4592-2987
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).ORCID iD: 0000-0003-0077-9061
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-9300-6422
Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden.
2024 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, no 1, p. 240-248Article in journal (Refereed) Published
Abstract [en]

Background: Being a significant other (SO) to a person with borderline personalitydisorder (BPD) affect their health. High incidence of substance use disorder, posttraumaticstress disorder, stress, fear, anxiety, depression, family burden and griefare common. Some specific therapies for BPD, have included support to SOs, howeverresources are scarce and to participate in the support it assumes that the personwith BPD is included in these therapies. Although the SO support has been shown tobe helpful, they all have a similar structure, and only a small exclusive group of SOshave access to the support.

Aim: The aim was to describe experiences and need of support for significant othersto persons with borderline personality disorder from the perspective of themselvesand of health care workers.

Methods: Data was collected via two focus groups. One with five SOs to personswith BPD, one with five health care workers. Two interview sessions in each groupwere conducted and data were analysed with qualitative content analysis. The studywas approved by the research ethics committee of Lund (2016–1026).

Results: The results revealed four themes; not being seen by health care professionalscreates hopelessness, being seen by healthcare professionals creates trust, experienceof support - helpful or shameful and the step from loosely structured supportto a structured support group. Both groups expressed a need for further support as acomplement to already existing support.

Conclusions: The need of support is extensive. The results suggest a professionalcoordinator intended for SOs and peer support groups not linked to a particular psychiatrictreatment yet offering support in a structured way. Further studies examiningthese complements to existing support, is therefore recommended.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2024. Vol. 38, no 1, p. 240-248
Keywords [en]
borderline personality disorder, family, focus group interviews, relatives, support
National Category
Nursing
Research subject
Care science
Identifiers
URN: urn:nbn:se:mau:diva-63180DOI: 10.1111/scs.13221ISI: 001085098200001PubMedID: 37846882Scopus ID: 2-s2.0-85174242640OAI: oai:DiVA.org:mau-63180DiVA, id: diva2:1805627
Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2024-09-09Bibliographically approved
In thesis
1. Från maktlöshet till empowerment: upplevelser av att vara närstående till en person med borderlinepersonlighetssyndrom/ emotionell instabilt personlighetssyndrom, bemötandet från hälso- och sjukvården, deras behov av stöd och känsla av empowerment
Open this publication in new window or tab >>Från maktlöshet till empowerment: upplevelser av att vara närstående till en person med borderlinepersonlighetssyndrom/ emotionell instabilt personlighetssyndrom, bemötandet från hälso- och sjukvården, deras behov av stöd och känsla av empowerment
2024 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Being a significant other to a person with borderline personality disorder affects life in several ways. Stress, depression, anxiety and a heavy family burden arecommon, as well as feelings of shame and guilt, depowerment and stigmatisation. Support from health care in Sweden is available, albeit to a limited extent. One explanation is that in order to be offered support from health care, in most cases, persons with borderline personality disorder are assumed to be under treatment. This issue, in combination with limited resources, excludes a large group of significant others. Previous research has emphasized the need for development of further support for this group. Support should include knowledge regarding the diagnose, how to decrease family burden and stigmatisation, and focus on increasing empowerment.The overall aim of this thesis was to describe experiences of being a significant other to a person with borderline personality disorder, their needs and experiencesof support, and their sense of empowerment. The thesis consisted of four studies. Studies I, III and IV had a qualitative design, and study II had a descriptive mixed method design. All four studies were analyzed with qualitative content analyses. In the second study descriptive inferential statistics were used for the quantitative section. The first study aimed to explore significant others’ experiences of living close to someone with borderline personality disorder and their encounters with health care. A semistructured questionnaire was used followed by group interviews. The next study aimed to describe significant others’ experiences of a healthcare-providedsupport known as family skills training, their life situation before and after support, and measuring their levels of anxiety and depression symptoms beforeand after completed group participation. A semi-structured questionnaire was used and followed up by group interviews in the qualitative section. In the quantitative section the hospital anxiety and depression scale were used. The third study aimed to focus on experiences and need of support from the perspective ofsignificant others themselves and of health care professionals. Two focus group interviews were carried out in each group. The fourth study aimed to illustrate significant others’ sense of being empowered after participation in an empowerment-based support group with the help of individual interviews.The results from all four studies described how significant others’ both physicaland mental wellbeing were adversely affected due to their role. A poor encounterfrom health care professionals created feelings of hopelessness andstigmatisation, and the need for support was crucial. The poor encounter seemedto be associated with a lack of knowledge However, the support described instudies II and IV showed promising results. The time spent in the support groupsseemed to strengthen the significant others in a positive way, and their feelingsof empowerment increased. Studies I and III highlighted peer support organisedas an association specially for significant others as an important support effort. Instudy III one concrete example of support was spoken of in terms of aprofessional coordinator, with special knowledge regarding the significantothers’ situation and needs.Two findings emerged from the overall results. Firstly, it appears to be importantto offer correct support, at the right level and at the right time. Secondly,acceptance may play an important role when it comes to increased empowerment.These findings indicate the importance of various types of support efforts wheresignificant others can choose support efforts based on their specific needs. The conclusion of this thesis emphasises two areas that would benefit by further development. The first area includes development of increased knowledge for health care professionals where two measures are suggested: 1) development of a knowledge support regarding borderline personality disorder and its effects onsignificant others, 2) updating the Swedish clinical guidelines regarding the careof persons with borderline personality disorder from the perspective of significantothers. The second area includes the need of extended support for significant others. Three measures are suggested for development: 1) empowerment-basedpeer support groups, 2) a professional coordinator and 3) a digital platform with the possibility to choose support efforts based on the significant others specificneeds at the time. With support from the results of this thesis it is recommended that the measures regarding both areas are to be furthered examined.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2024. p. 100
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277 ; 12
National Category
Nursing
Research subject
Care science
Identifiers
urn:nbn:se:mau:diva-70893 (URN)10.24834/isbn.9789178775156 (DOI)978-91-7877-514-9 (ISBN)978-91-7877-515-6 (ISBN)
Public defence
2024-09-20, HS Aula, Jan Waldenströms gata 25, Malmö, 09:00
Opponent
Supervisors
Note

Paper IV in dissertation as manuscript. 

Available from: 2024-09-10 Created: 2024-09-09 Last updated: 2024-09-10Bibliographically approved

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Ekdahl, SusanneCarlson, ElisabethIdvall, Ewa

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