From judgment to understanding: mental health nurses' perceptions of changed professional behaviors following positively changed attitudes toward self-harm.

Nurses experience feelings of frustration, anger and fear when caring for patients who self-harm. Training programmes were developed that aimed to positively influence nurses' knowledge, attitudes and skills. The aim of this study was to investigate professional behavior of mental health nurses with positively changed attitudes after following a training program. Using grounded theory, semi-structured interviews were conducted with 11 mental health nurses. Participants reported using less restrictive interventions, being more patient oriented, and choosing a more empathic and exploratory approach after the training. A work environment conductive to making autonomous professional decisions with supportive colleagues enabled these changes.

Collaborative Care for Patients With Severe Personality Disorders: Preliminary Results and Active Ingredients From a Pilot Study (Part I).

PURPOSE: To test if a collaborative care program (CCP) with nurses in a coordinating position is beneficial for patients with severe personality disorders. DESIGN AND METHODS: A pilot study with a comparative multiple case study design using mixed methods investigating active ingredients and preliminary results. FINDINGS: Most patients, their informal caregivers, and nurses value (parts of) the CCP positively; preliminary results show a significant decrease in severity of borderline symptoms. PRACTICE IMPLICATIONS: With the CCP, we may expand the supply of available treatments for patients with (severe) personality disorders, but a larger randomized controlled trial is warranted to confirm our preliminary results.

Collaborative Care for Patients With Severe Personality Disorders: Analyzing the Execution Process in a Pilot Study (Part II).

PURPOSE: To examine the factors that influence the effective execution of a collaborative care program (CCP) for patients with severe personality disorders. DESIGN AND METHODS: A multiple case study using qualitative research methods. FINDINGS: Three factors were identified as influencing the execution process: (a) the context in which the CCP was executed, (b) the patient population, and (c) the individual application of the CCP by nurses. PRACTICE IMPLICATIONS: The prominent position of mental health nurses in complex intervention programs such as CCPs poses new challenges for them in making these programs work. A CCP could be a useful intervention for patients with severe personality disorders because it offers the necessary structure in treatment.