Chapter 4: Main Findings
Introduction
As the primary goal of most global healthcare facilities is to provide quality patient care services based on equity, the study extrapolated a keen analysis of gender bias as well as the perspectives of clinic practitioners toward borderline personality disorder (BPD) (Travis et al., 2004). The motive is to establish evidence-based grounds for improvements. The use of NVivo software to manipulate the textual data sourced from interviews is key to discerning the bottom-line based on implications. As a result, this section presents a detailed overview of the findings that are reliant on the qualitative analysis via a set of well-defined textual data sets in correspondent to the interview questions.
Key to note, the choice of the NVivo software for the analysis sprung from the relevance of anticipated outcomes to reforming healthcare facilities based on professional approaches as well as behavioural factors among practitioners that add value to the result of patient care. Based on the background developed in the previous chapters, the BPD disorder is mental. Besides, the software was selected for the study as it is befitting to the anticipated outcomes of the study based on the clearly comprehensive background that is developed from the works of previous psychological and health scholars.
Results from NVivo
From the NVivo-based findings, it is clear that a more substantial assortment of the practitioners in the Canadian healthcare system reveals a sense of concurrence when it comes to the use of DSM-5 technique in diagnosing borderline personality disorder (BPD). From the NVivo software’s text search query, Figure 4.1 below presents the word tree results for the DSM-5 diagnosis approach. Despite the general understanding that the use of such benchmarked diagnostic approaches could help alleviate performance issues, its increased use in diagnosing BPD among other cognitive and mental disorders raises a wide range of unanswered questions, especially regarding the effectiveness of the selected diagnosis procedure in the context of BPD. As revealed in the final report of the NVivo analysis project, pre-meditated judgements and assumptions could be prolific contributors to misdiagnosed cases of BPD as well as the dissatisfying and prejudiced access to quality patient care that is founded on professional enthusiasm and know-how of the disorder among the medical practitioners.
However, an essential element of the findings, which is worth spelling out, is the specific information that practitioners use to dictate whether the mental and cognitive-based symptoms are particular implications for the prevalence of borderline personality symptoms. To differentiate from other mental disorders such as post-traumatic stress disorder (PTSD), bipolar, and depression, more than 80% of the respondents asserted that suicidal ideation is the vital key indicator for the prevalence of borderline personality disorder (BPD) (Woodward et al., 2009). As such, the findings of the study show an association of women to the incapacity to regulate their emotions, especially when subjected to compromising phenomenon socially.
As the respondents clarify on the issue of emotional control and suicidal ideation among women, NVivo’s analytical findings not only show a sense of gender bias in healthcare facilities when it comes to taking up responsibilities of patient care. Generally, women are vulnerable to BPD because of the ways they are socialized in most cultures. Figure 4.2 below further makes it more precise and comprehensive how the concept of socializing women reflects the tendencies for BPD diagnosis, particularly in the Canadian cultural context. This leads to logical reasoning that task allocation, male chauvinism, and limited, compromised liberty together add meaning to the rampant cases of females that are diagnosed with a borderline personality disorder as compared to men. However, it is also, notable and arguable that gender bias plays a role in not only pardoning men when it comes to diagnosing with BPD but also explains the increased chances of associating men with an extreme emotional response such as anger with anger management and not borderline personality disorder (BPD) (Veague & Hooley, 2014). Although, not many practitioners relate with this concept but the few who do help the NVivo analysis in distinguishing why most women register BPD diagnoses compared to Canadian, in light of the purposively selected respondents for the study.
Besides, diagnosis using the DSM-5 methodology, the final project report reveals that more than 67% of the respondents show a pre-meditated notion of gender bias when it comes to the resultant behaviours that relate to BPD symptoms. Such that a majority of the respondents reveal a correlation between gender and the capacity to contain the undesirable behavioural symptoms of the disorder. Precisely, male patients tend to contain the disorder better than their female counterparts. To elaborate on this claim, the word tree compiled for Figure 4.2 below indicates the way women are centred in the biased treatment criterion. Also, it is arguable that BDP symptoms can be rampantly prevented in women as compared to men. Healthcare practitioners that were interviewed (the study’s respondents) show that there is a relationship between the psychiatrists’ understanding of BPD and the manifestation of gender bias during diagnosis and treatment.
Figure 4.1: Word Tree from NVivo text search query findings
Similarly, other than the correlation between gender and behavioural symptoms of BPD, most respondent practitioners reveal that perceptions and pre-meditated assumptions play a core role in defining the prejudiced patient care among the Canadian female BPD victims. For example, trauma appears along the chain of causality owing to its impact on the mental and cognitive systems. As shown in Figure 4.3, trauma is one of the words the NVivo analysis finds to appear frequently among the reasons behind a lack of equilibrium in the practitioners’ approach. The inclined bias is dependent on gender because trauma plays a more significant role in displaying the BPD symptoms in Canadian female patients more than their male counterparts. These findings lead to an argument that since the mental and cognitive disorder jeopardizes the patients’ capacities in managing their emotions, practitioners’ perceptions lead to a definition of the techniques that could be preferably applied in the diagnosis and treatment stages as well as the readiness to deal with the negative side of the disorder symptoms during the patient care period. In this case, biases spring from lots of pre-judgmental perspectives.
For instance, physicians and psychiatrists tend to prefer dealing with males to females owing to the incapacity to regulate emotions and feelings when diagnosed with the BPD. Also, the sense of bias extrapolates to diagnosis and treatment procedures whereby it is easy for other mental patients to be wrongfully diagnosed with BPD on account of their inability to control their emotions or when they get to points of manifesting suicidal ideations. This assertion implies potentially high chances of misdiagnosis based on gender bias. On the one hand, female Canadian patients stand more chances of being wrongly diagnosed with BPD using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). On the other hand, men also stand chances of misdiagnosis with other disorders like anger management amid depicting symptoms of borderline personality disorder (BPD) just because of a gender-based bias.
From this NVivo software analysis of the textual data sets from the interview results, it is arguable regarding the accuracy and rigour of the findings. As shown in Figure 4.3, the word cloud portrait depicts Borderline Personality Disorder as the three outstanding words that appear in almost all the responses. Well, the study is centred on the disorders’ diagnosis and associated perspectives that invite gender bias during diagnosis, treatment, and therapeutics. The phrase appears in almost every section of the empirical study and the interview, alike. In this context, it is assurance for the rigour and validity of the findings extracted from the NVivo software.
Figure 4.2: Word Tree for the NVivo text search query findings
Figure 4.3: Word cloud from the NVivo overall text frequency search
Conclusion of the Findings
In summary, the NVivo software analysis shows correlated findings from the respondents’ understanding of gender bias and healthcare practitioners’ perceptions when diagnosing and treating borderline personality disorder among Canadian patients. The findings lead to an empirical conclusion that there is an inevitable correlation between what psychiatric practitioners know about BPD and the unfolding of gender bias in the course of diagnosis. Further, females are more prone to BPD symptoms compared to men because of how they are socialized across the Canadian cultural dimensions. The high tendency to manifest uncontrollable emotions also sparks a sense of fright and avoidance among practitioners. Notably, the DSM-5 technique stands out as the benchmarked primary diagnosis approach for almost all mental disorders. This criterion also promotes the increasing building of stereotypes regarding the potentiality of BPD’s prevalence.
Woodward, H. E., Taft, C. T., Gordon, R. A., & Meis, L. A. (2009). Clinician bias in the diagnosis of post-traumatic stress disorder and borderline personality disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 1(4), 282.
Veague, H. B., & Hooley, J. M. (2014). Enhanced sensitivity and response bias for male anger in women with a borderline personality disorder. Psychiatry Research, 215(3), 687-693.
Travis, P., Bennett, S., Haines, A., Pang, T., Bhutta, Z., Hyder, A. A., & Evans, T. (2004). Overcoming health-systems constraints to achieve the Millennium Development Goals. The Lancet, 364(9437), 900-906.