This text is part of the special Research section
Hospitalized for a medical condition a few years ago, Cathy Martineau saw impatient, distant, judgmental nurses on patients with borderline personality disorder (BPD). “I told myself that these are people who are suffering a lot, that this is not the right way to help them. She is now studying the behaviors of caregivers towards people with this mental illness as part of a research project.
Individuals living with BPD—or disorder borderline, according to the more widespread term — do not have the tools to properly express their pain, explains in an interview the candidate for the master’s degree in nursing sciences. “To communicate it, they use methods they learned in childhood, which can be destructive and often the nurses don’t understand them. They say: “why do they cut themselves, why do they mutilate themselves?” “, illustrates Cathy Martineau.
“Ha! Another TPL. is the kind of comments she heard in the hospital. “As if the diagnosis carried in itself a very heavy and stigmatizing burden. It erases the person behind a little, ”she laments.
A dozen scientific studies have already documented the behavior of nurses with individuals with BPD. Their conclusions are worrying: caregivers underestimate the impact of their pathology and often have a negative opinion of them, perceiving them as dangerous and manipulative. In listing the studies, Cathy Martineau understood that she had to look into the problem in her turn: “I saw that there weren’t really any in Quebec. »
As part of her master’s degree conducted at the University of Quebec in Rimouski (UQAR), the researcher recruited 303 nurses practicing in different sectors: hospitals, clinics, community organizations, call lines. The latter completed a questionnaire that assessed four aspects: their socio-demographic characteristics (age, level of education), their ability to work with patients suffering from BPD (number of experiences, training), their level of empathy and their personality.
“The purpose of my research was to see if there is anything in the personal or professional characteristics of nurses that allows us to predict their attitudes [envers la clientèle ayant un diagnostic de TPL] “, popularizes Cathy Martineau.
Although the results are still being analyzed, it is already possible to conclude that certain factors determine the behavior of a nurse: her motivation, her empathy and her care unit. The more she is motivated, the more her gestures and words are appropriate and benevolent, and the same is true from the point of view of empathy. Those who work in mental health would also adopt a better posture.
In the questionnaires, some also testified that they perceived these patients as manipulative people, in need of being taken care of.
Gap in teaching
According to the Center for Addiction and Mental Health, BPD is a “serious, chronic, and complex mental health condition. People who have it have difficulty containing their emotions or controlling their impulses. They are extremely sensitive to what is happening around them and can react with intense emotions to small changes in their environment”. Symptoms may include short and powerful episodes of anger, depression or anxiety, feelings of emptiness, paranoid thoughts, dissociative states, fluctuating identity, compulsive behaviors (alcohol, drugs, overeating, gambling , etc.), self-harm, unstable relationships, and even suicidal thoughts. About 10% of people who suffer from it end their life.
While this disorder seems well documented, however, nurses lack, according to Cathy Martineau, training about the disease. And she is well placed to know it, because she practices the trade herself. For five years, she has worked for Info-Santé. “I’m sure I’m done [ma technique en sciences infirmières] in 2005, but there was, I think, barely an hour allocated to the TPL. Patients who suffer from it are complex. They are hospitalized a lot, they consult at the emergency room. »
If the program has since been modified, we can still do better, believes the graduate student. To the question “I feel well equipped and competent” with regard to this pathology, several participants answered in the negative. Cathy Martineau then wishes, as part of a doctorate, to develop tools and thus improve nursing practice.
This special content was produced by the Special Publications team of the Duty, relating to marketing. The drafting of Duty did not take part.
According to a dozen scientific studies, caregivers underestimate the impact of the pathology and often have a negative opinion of individuals with BPD, perceiving them as dangerous and manipulative.