Borderline Personality Disorder: Social Rejection and Dangerousness - Research Paper Example

Critique of Published Research Title of the article: Attitudes towards patients with a diagnosis of borderline personality disorder: social rejection and dangerousness. This primary research authored by Markham Dominic, sought to determine the kind of attitude exhibited by nurses working in a mental health institution towards people working with borderline personality disorder. It is evident that an individual with a personality disorder will receive a label either from the society or from the staff working in institutions that offer help to such patients. Previous research indicates that labeling such patients with such personality disorders has its effects (Markham 2003, p.595). Markham focused on determining whether stuff working in mental health institutions rejected patients with borderline personality disorder at a higher rate compared to the rejection subjected to the patients with schizophrenia or depression. From the abstract of the paper the reader can identify the main issue in the research. This is because the abstract has all the relevant elements, namely the background information, introduction, aims of the research, rationale of the research, hypothesis of the research, methodology of the research, finding s and conclusions (Markham 2003, p.595). The concision of the abstract serves as evidence to the reader that the research has followed the right format and has all the required sections. From the title of the paper, the reader can identify the issues accorded attention in the research. Prior to a detailed critique of the paper, assessment of the quality of the primary research requires a close analysis of the title and the abstract. Methods employed in this research This research utilized a repeated measures factorial design. This research design allowed the author to carry out repeated studies of the way mental health nurses and health care assistants treated people with borderline personality disorders schizophrenia and depression. This implied that the selected participants comprising of fifty nurses and twenty one health care assistants filled in three sets of identical questionnaires (Markham 2003, p.597). In each case, the researcher allowed a measure of balance to ensure that credible results would emanate from the research. Therefore the questionnaires for each disorder were handled in the same way. Four factors were considered in this research. They include, social distance, staff optimism, believes about dangerousness and working experience. For these four measures, all the participants rated their views in accordance to selected pointer scales for each factor. For example, in the case for social distance, nurses indicted their opinion from a range of eleven statements that define a five-point scale. This research is an interpretive approach of understanding the attitudes exhibited by staff in mental health institutions towards patients with borderline personality disorder (Crotty 1998, p. 45). The author sought to compare the differences in attitudes evident in health care staff in mental health institutions regarding different patients. Notably the focus of the author was to outline the different attitudes exhibited by nurses towards nurses towards patients with borderline personality disorder. From the literature review provided by the author there is a justification for this approach because previous researchers have highlighted that nurses in mental health institutions viewed patients with borderline personality disorder as more dangerous and hence rejected them at a higher rate compared to other patients. Evidently the research made use of health care workers in mental institutions to obtain the data used in this research. Effective statistical tools such as one way ANOVAs were used to analyze the date used from the research (Holloway & Wheeler 2013, p. 89). The author sought ethical approval from the relevant boy as required in any research. Moreover, participants gave their consent before filling in the questionnaires. Participation was a voluntary choice for all the fifty nurses and twenty one health care assistants who provided data for this study. Absence of such ethical considerations would serve to compromise the quality standards of the research. As hypothesized by the author, at the beginning of the research, it became evident that there was difference in the way nurses and other health care providers in other mental institutions viewed borderline personality disorder patients when compared to label of schizophrenia or depression. In order to adopt or reject this hypothesis, the researcher needed to develop a research design that provided data that can either support or disagree with the hypotheses. Notably the repeated measures factorial design proves to be an effective methodology in obtaining data for this research (Markham 2003, p. 600). The fact that participants filled in identical questionnaires for each case serve to provide data for comparison of attitudes exhibited towards patients with the three different labels. Relevance of Findings and conclusions The findings of the research highlighted that mental health nurses and other health care assistants exhibited an extreme level of rejection of BPD patients in comparison to patients of schizophrenia and depression. Patients with borderline personality disorder were perceived to be more dangerous than other patients moreover, staff exhibited limited optimism towards patients with BPD. The conclusions drawn from this research conform to the finding described by the author. The author exhibited expertise in the definition of the purpose of the study, the relevant paradigm, and methodology and data analysis technique (Markham 2003, p.605). The author embarked on this study seeking to outline how different nurses and health care assistants exhibited the diversity of perception regarding different patients (Markham 2003, p.612). It becomes evident that the author adopted a constructivist epistemology because of the following factors: 1. Outline of multiple conceptual frameworks that potentially affect the perception of nurses and health care assistants as it is evident in the four measures tackled. 2. Discussion of three varying disorders. 3. Discussion of diverse perceptions of staff concerning the different patients. Strength and the Limitations of the Research The methodology selected for this research proved successful, yielding sufficient data for the three cases analysed. Since the focus of the research was on borderline personality disorder, comparison of data obtained from nurses regarding patients with this condition revealed that health care staff had minimal hope with BPD patients (Markham 2003, p.608). One of the salient limitations of the methodology adopted in this research is the possibility of nurses offering biased views. This may result if nurses do not maintain a balanced attitude when handling the three questionnaires. This will limit the availability of genuine data that help in the required comparison. Relevance of the frameworks and methodology used in research The sequential manner translates to the fact that the epistemology chosen by the author determines the theoretical framework that the researcher settles for. Consequently, the chosen theory determines the research approaches that the researcher will choose to use (Rogers and Dunne 2011, p. 232). Finally, the chosen approaches determine the relevant strategies used in data collection and analysis. In the article under critique, the author settled for a constructivist epistemology that sought to identify the diverse perceptions of nurses and health care assistants concerning patients with BPD, depression, and schizophrenia (Markham 2003, p. 601). This epistemology influenced the researcher’s choice of interpretivism as the most relevant theory. Consequently, the author settled for the grounded theory approach as a powerful approach suitable for constructivist epistemologies. The choice of the grounded theory approach influenced the author’s choice for a close comparative analysis as one of the practices used in grounded theory approaches. These factors serve to explain why the author settled for the interpretivist approach. Through the interpretation of the results obtained, it became possible to either accept or reject the defined hypothesis. Although authors usually exhibit a combination of frameworks, one is usually outstanding. This is evident in the article described, proving that researchers may operate within all the frameworks, although, but one may appear more predominant. In this case, the interpretivist framework proves dominant. Strategies used in the research Strategies denote all the practices that a researcher employs in data collection, analysis and presentation. Markham relied on three different sets of questionnaires filled in by each participant to solicit the data used in the research. For data analysis, the author settled for a close comparison analysis of the data obtained from the different questionnaires. Credibility of the findings In this research, the author began by exploring the views and attitudes of nurses regarding different patients with disorders. Using a repeated multi-factorial design, data was obtained for three of the disorders. The authors outlined how the staff viewed BPD patients, while comparing how they viewed schizophrenia and depression patients. This offered a valid basis of comparison, making the findings exhibit a high level of credibility (Markham 2003, p.605). Title of the Article: “They told me I had this personality disorder… all of a sudden I was wasting their time”:personality disorder and the inpatient experience Rogers Bertha and Emma Dunne are the authors of this article whose main purpose was to determine the real experiences of patients with personality disorders in mental institutions where they received services to address their complications. The researchers were prompted to carry out this research because of the lack of availability of previous studies that analysed the experiences of the patients with personality disorders when compelled to live in a health care setting. The reason why patients with personality disorders are sent to mental health care institutions is because previous researches has indicated that there is the need for such individuals to access the pertinent help to return to normalcy (Rogers and Dunne 2011, p. 230). Previous researches have only focused on psychological issues that determine the diagnostic possibility of personality disorders. None of those studies has involved the service users who were once suffering from personality disorders. Most of the previous studies relied on the views of the nurses and other health care assistants to define the behavioral patterns of personality disorder patients. Such an approach has made it impossible to understand the diverse range of feelings exhibited by service user. All previous researches have relied on data obtained from nurses. The authors of this article sought to obtain data from the patients themselves. This was one of the obvious strengths of this research of this paper, as the participants had the power to determine the credibility of the research (Rogers and Dunne 2011, p. 228). This only served to reveal certain aspects of the feelings exhibited by the health care providers. This was evidently an interpretivist research that sought to offer descriptions of the diverse range of attitudes that many mental health care staff had demonstrated. Community personality disorder service (CPDS) focused on developing focus group that analyzed the experiences of previous service users of the program. Relevance of the adopted paradigm Positivism and interpretivism appear to be the choice of many researchers in social science. In the article described above, the authors settled for interpretivism, a theory that is evident in the outlining of various conceptual frameworks that had the potential of affecting the experiences of patients in the CPDS (Rogers and Dunne 2011, p. 227). After identifying these frameworks, the research focused on determining the various perceptions that former service users have developed over time. The authors then ventured into interviews and observations that would reveal the various experiences of the focus group. The presence of the perceived definitions of their disorder, and relating such with the focus of their experiences in the article ascertain that the author settled for interpretivism (Thorne 2008, p. 78). Moreover, authors offer a vivid explanation and citations of the patients in order to bring out the rationality in each. In the discussion section, the article offers a description of the factors that determined the perception of each patient. Relevance of the Research methodology As experts have highlighted, the chosen paradigm framework serves to lay the context for the approaches that researchers can adopt (Taylor 2006, p.65). This hierarchical relationship culminates in the approaches determining the data collection and analysis strategies. However, this critique realizes the fact that the interaction of these dimensions does not always follow the sequence defined, but may also exert influence on each other at varying levels. Sometimes a researcher may choose certain strategies that affect the epistemological position adopted in the research altering prior epistemologies. Experts have noted that many researchers seek to identify a specific research question. Understanding of the research question then helps them identify the specific approaches and strategies. However, it proves impossible to derive the theoretical frameworks prior to determining the epistemology (Preissle 2006, p. 690). This hierarchy is evident when one considers the methodology, data collection, and data analysis techniques adopted in this research (Rogers and Dunne 2011, p. 226). Evidently, the thematic analysis chosen for this research was of critical significance, and conformed to the identified framework. The authors settled for an interpretativistic study in a bid to identify and elaborate the factors that determine the self perception of patients with personality disorder (MacLure 2003, p.78). In order to achieve this, they opted for a grounded theory approach, which is one of the definitive approaches in interpretativistic studies. As highlighted above, authors usually exhibit a combination of frameworks, but that one is usually outstanding. This is evident in the article described, proving that researchers may operate within all the frameworks although, but one may appear more predominant. In this case, the interpretivists framework proves dominant (Rogers and Dunne 2011, p. 226). Relevance of the findings The definition of five outstanding themes that define the experiences of service users of the focus group exhibits credibility in view of the strategies used in the data collection and analysis (Polit & Beck 2010, p.78). The findings are critical in addressing the defined research question, and meet the purpose of the paper. The findings highlighted multiple factors that determined the self-perception of patients with personality disorders. Ethical considerations in this research Since all the women in the CPDS group received invitation to the focus group through flyers and made a choice on whether to attend or not, the research observed ethical standards that require the obtaining of voluntary consent from the participants. Similarities in Frameworks used in both primary researches Both researches sought to address research questions related to borderline personality disorder. In real research, different factors exhibit interactions at different levels. The sequence of the interaction can change, as long as the researcher has identified the preferred epistemology. According to experts, the definition of the research question that a researcher seeks to address is critical in determining the relevant approaches and strategies of data collection and analysis. This critique appreciates all these ideas on analyzing research articles. In both researches, the authors settled for an interpretivist approach (Speziale & Carpenter 2011, p. 232). What the articles highlight about borderline personality disorder Borderline Personality Disorder (BPD) is a disorder characterized by the occurrence of interrupted moods of a person and alters social behavior of people. It is a disorder that registers remarkably high prevalence in women. Patients may exhibit violent social behavior, eventually proving to be dangerous to others in the society. This is true from Markham’s article that highlights the perception of nurses and health care providers on the dangerousness of the patients. Bibliography Crotty, M 1998, The foundations of social research: meaning and perspective in the research process, Australia: Allen & Unwin Pty Ltd. Holloway, I., & Wheeler, S 2013, Qualitative Research in Nursing and Healthcare, Chicester: Wiley. MacLure, M 2003, Discourse in educational and social research, Buckingham: Open University Press. Markham, D 2003, “Attitudes towards patients with a diagnosis of ‘borderline personality disorder’: Social rejection and dangerousness” Journal of Mental Health, 12(6), 595-612. Polit, D. F., & Beck, CT 2010, Essentials of nursing research: Appraising evidence for nursing practice, Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Preissle, J 2006, Envisioning qualitative inquiry: a view across four decades, International Journal of Qualitative Studies in Education, 19(6), 685-695. Rogers, B. and Dunne, E 2011, ‘“They told me I had personality disorder…All of asudden I was wasting their time”: Personality disorder and the inpatient experience’, Journal of Mental Health, 20(3), 226-233. Speziale, H. S., & Carpenter, DR 2011, Qualitative research in nursing: Advancing the humanistic imperative, Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Taylor, B. J., Kermode, S., Roberts, K., & Roberts, K 2006, Research in nursing and health care: Evidence for practice, South Melbourne, Vic., Australia: Thomson. Thorne, SE 2008, Interpretive description, Walnut Creek, CA: Left Coast Press. Read More