Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme (original) (raw)
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Caring for self-harming patients in general practice
Journal of Primary Health Care
INTRODUCTION Intentional self-harm is an international public health issue with high personal, social and financial costs to society. Poor relationship dynamics are known to have a negative influence on the psyche of people who self-harm, and this can increase anxiety and decrease self-esteem, both shown to be significant contributors to self-harm behaviours. Positive and functional social supports have been proposed as a cost-effective and constructive approach in diminishing self-harming behaviours. AIM This qualitative study investigated the aspects of professional, social, familial and romantic relationships that people who have self-harmed identified as having a positive and constructive effect on their self-harm behaviour. METHODS Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years, and represented New Zealand (NZ) European and Māori from ...
A study of service providers' understanding of self-harm
Journal of Mental Health, 2002
An understanding of self-harm among various occupational groups who may be involved in caring for and supporting people who self-harm was investigated. A questionnaire was constructed to assess understanding of self-harm. It was completed by a number of occupational groups including psychiatrists, psychologists, medical workers (general practitioners and nurses) and social/community care workers. It was also completed by a group of individuals who engage in deliberate self-harm. The results showed psychiatrists and medical workers have a poorer understanding of self-harm in comparison to self-harmers and workers with psychological or social/community care training. Psychology workers, self-harmers and social/community care workers did not differ significantly in their understanding of self-harm. It was concluded that there is a need to enhance awareness and understanding of self-harm among psychiatrists and medical workers so that the referral and treatment process may be more accurately targeted towards the needs of the individual.
Working with self-harm: accounts of two staff groups
Journal of Learning Disabilities and Offending Behaviour, 2011
This study explores the content analysis of two qualitative studies. Both groups of staff interviewed in this study worked with people with learning disabilities who selfharm. The sample was taken from nurses from both medium security and low security.
The Journal of Emergency Medicine, 2012
Background: Past self-harming behavior is one of the most significant predictors of future suicide. Each year in Ireland there are approximately 11,000 presentations of self-harm to emergency departments (EDs) across the country. Study Objectives: This study examines predictors of perceived personal effectiveness in dealing with selfharming patients as reported by ED staff. The predictors are derived from past research and are influenced by Bandura's Social Cognitive Theory. Method: One hundred twenty-five ED medical staff (28 doctors and 97 nurses) from five EDs in the West and South of Ireland completed a questionnaire. Predictor variables included in the design, and informed by past research, included knowledge of self-harm and suicidal behavior and confidence in dealing with incidents of self-harm. Results: Standard multiple regression suggested a statistically significant model fit between the two predictors and the criterion variable, accounting for 24% of total variance. Knowledge and Confidence were significant contributors to perceived personal effectiveness in dealing with self-harming patients. Conclusions: Little is known regarding specific factors that influence perceived effectiveness in dealing with self-harming patients in the ED setting. These findings have implications for psychoeducation and training content for staff. The findings suggest that increasing knowledge of self-harm and confidence in dealing with self-harming patients can lead to more positive perceived personal effectiveness in responding to clients' needs. Ó 2012 Elsevier Inc.
CARE: A framework for responding therapeutically to the client who self‐harms
The CARE framework is a relevant, flexible and practical tool that can be used to map out a plan of care for helping the client who deliberately self-harms. A clear framework for care is useful for clinicians and consumers because ideally it provides a standard, holistic and considered approach for what is a complex health care issue. This paper recounts a story from clinical experience in which the CARE framework was applied. In this encounter, the nurse was helped to move beyond the limitations of the medical model towards an approach which proved satisfying for the health professional, and awakening for the client.
Services for assessment, aftercare, and psychological treatment following self-harm
Psychiatry, 2009
effective intervention following self-harm is vital because of the strong link between self-harm and suicide. Unfortunately, services for people who self-harm have been poor in the UK and elsewhere. in 2004, the national institute for Health and clinical excellence issued a guideline setting out clear standards for care following self-harm, many of which are included in this article. Whether this guideline has led to much needed improvements in care is not clear; there are few published experiences concerning implementation of the guidance but some studies suggest that care continues to be unsatisfactory. the barriers to implementation of self-harm guidelines are not clear, but the lack of definitive research evidence for effective treatments is a potential candidate. several systematic reviews have failed to demonstrate a statistically significant reduction in fatal or non-fatal repetition following intervention after self-harm. recent studies have, however, shown clear benefits for some psychological therapies -in particular for cognitive behavioural therapy with a problem-solving element. Promising results have also been demonstrated for some brief interventions designed to encourage uptake of aftercare following self-harm. this article sets out a little of the evidence for these potentially beneficial interventions, including recent developments in research evidence and implications for future research.
Archives of Suicide Research, 2017
Background Self-harm is an increasing phenomenon among young people, with potentially fatal outcomes. Patient's perceptions of treatment and support are poorly documented. 2 Aim The aim was to synthesise the experiences of those who self-harm, with special reference to professional care and support by family, friends and the school system. Method A systematic review of the literature was conducted. Results Following retrieval of 1,623 abstracts, 14 studies were included in the final analysis, 11 of which are reported here. Two quantitative studies as well as one mixed method study on self-care could not be reported on here due to word limitations. Adult people who self-harm described the importance of quality in the caring relationship and a tailored care designed for each individual. There is a need for more studies into adolescents who self-harm but of importance is the adolescents need for support from the adult world. Conclusions A positive relationship between patient and healthcare professional can be crucial in motivating continued treatment of people who self-harm. A major priority is radical improvement in the attitudes of healthcare personnel.
Mental Health Nurses’ Experiences of Caring for Patients Suffering from Self-Harm
Nursing Research and Practice, 2014
The aim of this study was to explore mental health nurses’ experiences of caring for inpatients who self-harm during an acute phase. The setting was four psychiatric clinics in Norway. Fifteen mental health nurses (MHNs) were recruited. Semistructured interviews comprised the method for data collection, with content analysis used for data analysis. Two main categories emerged: challenging and collaborative nurse-patient relationship and promoting well-being through nursing interventions. The underlying meaning of the main categories was interpreted and formulated as a latent theme: promoting person-centered care to patients suffering from self-harm. How MHNs promote care for self-harm patients can be described as a person-centered nursing process. MHNs, through the creation of a collaborative nurse-patient relationship, reflect upon nursing interventions and seek to understand each unique patient. The implication for clinical practice is that MHNs are in a position where they can pr...
A national survey of the hospital services for the management of adult deliberate self-harm
Psychiatric Bulletin, 2001
Aims and Method Services were compared for the management of deliberate self-harm with existing national guidance. A postal survey was sent to all clinical directors of adult psychiatry at all NHS trusts assessing adult patients admitted to general hospital following deliberate self-harm in England. Results Responses were received from 129 (65%) trusts.Thirty per cent of trusts do not use secondary psychiatric services for psycho-social assessment following deliberate self-harm; 52% have designated self-harm liaison staff and 69% of general hospitals have a ward to which most cases of deliberate selfharm are admitted. However, only 18% have staff with psychiatric experience. In 82% of trusts training is provided for junior psychiatrists at induction but in only 56% are observed-assessments undertaken. Forty-two per cent of the trusts have a deliberate self-harm services planning group. Clinical Implications Standards for deliberate self-harm services fall substantially below existin...