Self-harm in the emergency setting: Understanding and responding

Helping self-mutilating adolescents: descriptions of Finnish nurses

This study focused on the views of Finnish nurses in regards to providing help for adolescents who self-mutilate. Nine nurses participated, and when the interviews and written descriptions were qualitatively analysed, four main categories of information emerged. The first category comprises the nurses' views on self-mutilation. The second category describes the people who are able to be helpers. The third category describes the content of help, which is made up of a variety of acts provided by non-health professionals that promote the healthy development of adolescents. The fourth category describes care provided by nurses to adolescents who self-mutilate. Guidelines for caring for self-mutilating adolescents are needed, including information on the phenomenon of self-mutilation.

A systematic literature review: self-mutilation among adolescents as a phenomenon and help for it-what kind of knowledge is lacking?

The aim of this review article is to present current knowledge of self-mutilation among adolescents as a phenomenon and to define what kind of knowledge is lacking based on existing literature. The literature searches were executed in the CINAHL and Medline databases in 2010. The analysed data consisted of 126 articles and inductive content analysis was carried out. Existing knowledge of self-mutilation was categorized into the following two classes: (1) self-mutilation as a phenomenon and (2) caring for persons who self-mutilate or self-harm.

Deliberate self-harm: emergency department nurses? attitudes, triage and care intentions

AIM AND OBJECTIVES

This exploratory study investigates emergency department nurses' attitudes towards patients who engage in deliberate self-harm. It examines their attitudes towards, and triage and care decisions with, patients who self-harm.

BACKGROUND

Emergency department nurses sometimes show unsympathetic attitudes towards patients who present with self-harm and these can contribute to difficulties in assessing and providing appropriate care.

DESIGN

A modified version of the Suicide Opinion Questionnaire was used. A non-probability sample of 43 emergency department nurses from a large Australian hospital participated in the study. Data were analysed using SPSS.

RESULTS

Most nurses had received no educational preparation to care for patients with self-harm; over 20% claimed that the department either had no practice guidelines for deliberate self-harm or they did not know of their existence and one-third who knew of them had not read them. Overall, nurses had sympathetic attitudes towards patients who self-harm, including both professional and lay conceptualizations of deliberate self-harm. They did not discriminate against this group of patients in their triage and care decisions.

CONCLUSIONS

The findings of this exploratory study are important because attitudes can affect care decisions. Recommendations are made for improving the educational preparation of emergency department nurses, for improving awareness and implementation of practice guidelines, and for improving attitudes towards patients with deliberate self-harm. Further research is needed to confirm these results.