Salud Mental

Needs assessment of informal primary caregivers of patients with borderline personality disorder: psychometrics, characterization, and intervention proposal

##plugins.themes.bootstrap3.article.main##

Claudia de Mendieta
Rebeca Robles
Catalina González-Forteza
Iván Arango
Claudia Pérez-Islas
Beatriz Paulina Vázquez-Jaime
María Luisa Rascón

Abstract

Introduction. Informal Primary Caregivers (IPC) of people with borderline personality disorder (BPD) experience a significant burden, making it important to determine their specific needs.

Objectives. Cross-sectional study aimed at adapting and establishing the reliability of the Questionnaire on the Needs of Family Members of People with Severe Mental Disorders to identify felt and unfelt needs that may or may not have been met in IPCs of patients with BPD and suggest intervention strategies to effectively address them.

Method. The adapted version of the instrument was completed by 80 IPCs of patients with confirmed BPD diagnosis.

Results. Cronbach’s alpha coefficients for different groups of needs evaluated through the instrument were: Knowledge/information = .77, Instrumental support = . 78, Participation = .63, and Personal support = .74; and for the total score = .86. The most important unmet felt needs were: 1. having information on interventions for patients and caregivers, legal and administrative aspects, and available support services; 2. having coping skills to deal with crises and manage patients’ risk behaviors; 3. receiving professional care to reduce stress; and 4. being listened by health professionals, express their personal opinions, and need for rest.

Conclusions. The adapted instrument showed satisfactory internal consistency in IPCs of patients with BPD. The results highlight the urgent need for interventions for this population, focusing on psychoeducation, assertiveness training, stress management, and problem solving.
Keywords:
Assessment, informal primary caregivers, family, care needs, borderline personality disorder, questionnaire

References

Del Pino-Casado, R., Palomino-Moral, P., & Frías-Osuna, A. (2015). The association of satisfaction and/perceived burden/with anxiety/and depression in primary caregivers of dependent elderly relatives. Research in Nursing and health, 38(5), 384-391. doi: 10.1002/nur.21671

First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part I: Description. Journal of Personality Disorders, 9(2), 83-91. doi: 10.1521/pedi.1995.9.2.83

Fruzzetti, A. E., Santisteban, D. A., & Hoffman, P. D. (2007) Dialectical behavior therapy with families. New York: Guilford Press.

Giffin, J. R. (2008). Family experience of borderline personality disorder. Australian and New Zealand Journal of Family Therapy, 29(3), 133-138. doi: 10.1375/anft.29.3.133

Gómez, B., Ruiz, R., Palacios, M., Freund, L. L., & Fernández, L. (2012). Construcción y fiabilidad de un cuestionario para evaluar las necesidades familiares de personas con trastorno mental grave. Revista de la Asociación Española de Neuropsiquiatría, 32(115), 461-479. doi: 10.4321/S0211-57352012000300003

Guillen, A. (2011). Variables associated with the psychosocial needs of people with severe mental illness, users of community services and their family caregivers. Yearbook of Clinical Psychology and Health, 7, 15-24.

Hoffman, P. D., Fruzzetti, A. E., Buteau, E., Neiditch, E. R., Penney, D., Bruce, M. L., Hellman, F., & Struening, E. (2005). Family connections: A program for relatives of persons with borderline personality disorder. Family Process, 44(2), 217-225. doi.org/10.1111/j.1545-5300.2005.00055.x

McFarlane, W. R., Link, B., Dushay, R., Marchal, J., & Crilly, J. (1995). Psychoeducational multiple family groups: Four-year relapse outcome in schizophrenia. Family Process, 34(2), 127-144. doi: 10.1111/j.1545-5300.1995.00127.x

Morgan, J., Lowe, J., Lowe, L., & Rathod, S. (2010). An international perspective on what carers want ‒ the professional’s dilemma. International Journal of Social Psychiatry, 56(3), 211-213. doi: 10.1177/0020764009357701

Nunnally, J. C. (1991) Teoría Psicométrica. Mexico: Trillas.

Rapaport, J., Bellringer, S., Pinfold, V., & Huxley P. (2006). Carers and confidentiality in mental health care: considering the role of the carer’s assessment: a study of service users, carers’ and practitioners’ views. Health and social care in the community, 14(4), 357-365. doi: 10.1111/j.1365-2524.2006.00631.x

Segurana, M., & Bartel, R. (2016). Convivir con una persona con trastorno de personalidad límite. Vivencias de los familiares a través de un caso. Presencia. Salud Mental, Investigación y Humanidades, 12, 1-7.

Tennakoon, L., Fannon, D., Doku, V., O’Ceallaigh, S., Soni, W., Santamaria, M., … & Sharma, T. (2000). Experience of caregiving: relatives of people experiencing a first episode of psychosis. The British Journal of Psychiatry, 177(6), 529-533. doi: 10.1192/bjp.177.6.529