Bridging the Gap in Community Care for Patients With Borderline Personality Disorder: Protocol for Qualitative Inquiry Into Patient, Caregiver, and Clinician Perspectives on Service Gaps and Potential Solutions for Severe Emotion Dysregulation

Abstract

Background Borderline personality disorder (BPD) is characterized by severe emotion dysregulation that is often complicated by comorbid diagnoses, deliberate self-harm, and chronic suicidal ideation. Unfortunately, current care pathways for individuals with BPD are strained by limited resources, inadequate training, and an overuse of emergency departments and crisis teams. Such barriers result in delayed access to effective treatment, which increases risk of deterioration, disability, and morbidity. A first step toward addressing these limitations of the current care pathway is to understand key stakeholders’ lived experiences in this pathway and their perspectives on potential solutions. Objective The purpose of this paper is to present a protocol for a study that explores the lived experiences of the current care pathway from the perspectives of patients with BPD, as well as their caregivers and clinicians. Methods A qualitative approach is most appropriate for the exploratory nature of the research objective. Accordingly, 3 to 6 patients with a diagnosis of BPD, 3 caregivers of individuals with BPD, and 3 clinicians of patients diagnosed with BPD will be invited to participate in individual, semistructured interviews that focus on service experiences. Results It is anticipated that results will yield insight into the lived experiences of patients with BPD, caregivers, and clinicians and provide a better understanding of the perceived gaps in services and potential solutions. Results are expected to be available in 12 months. Conclusions This paper describes a protocol for a qualitative study that seeks to understand the lived experiences and perspectives of key stakeholders (patients, caregivers, and clinicians) on the current care pathway for BPD. Results will provide a basis for future research in this area and will have the potential to inform training, practice, and policy. International Registered Report Identifier (IRRID) DERR1-10.2196/14885

Key stakeholders’ experiences and expectations of the care system for individuals affected by borderline personality disorder: An interpretative phenomenological analysis towards co-production of care

“…Qualitative interpretative phenomenological analysis methodology [ 43 ] was used to explore the experiences of having BPD or supporting an individual with BPD, and to learn about stakeholder perspectives of what is needed to fill gaps in current healthcare systems. For a detailed account of the methods, procedures, and evidentiary support for the soundness of this in-depth study, the reader is directed to the published research protocol: https://www.researchprotocols.org/2020/8/e14885 [PROTOCOL DOI] [ 44 ]. The current study received ethical clearance from the University of Alberta’s Health Ethics Research Board (Ref.…”

“…Following extensive analyses, starting with ideographic analyses which were then followed by within, then across-group analyses, the findings were evaluated carefully and rigorously with the support and review of the research team. Evaluative criteria were followed to increase the findings’ trustworthiness, comprehensiveness, usefulness, persuasiveness, and coherence [ 48 , 49 ], a process that is detailed in the published research protocol [ 44 ]. Examples of verification methods used to enhance the goodness of the qualitative research included member-checking in the interview and audits by and with the research team.…”