Interpersonal processes and self‐injury: a qualitative study using Bricolage

Rayner, Gillian; Warne, Tony

doi:10.1111/jpm.12277

Cited by 18 publications

(31 citation statements)

References 35 publications

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“…The literature is replete with findings suggesting that healthcare professionals' responses to those who self-harm are often negative and that a lack of understanding about self-harm contributes to these negative attitudes (Commons Treloar & Lewis 2008;Dickinson & Hurley 2011;Dickinson et al 2009;Gibb et al 2010;Karman et al 2015;Kool et al 2014;O'Connor & Glover 2017;O'Donovan & Gijbels 2006;Patterson et al 2007;Rayner & Warne 2016;Saunders et al 2012; Thompson et al 2008;Tofthagen et al 2014;Wilstrand et al 2007). While there is less research available from the perspective of service users, existing studies identify poor treatment experiences and report that the care received from some mental health professionals is substandard due to unhelpful attitudes displayed (Lindgren et al 2018;Pembroke 2006).…”

Section: Introductionmentioning

confidence: 99%

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

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Caring for people who self‐harm is an everyday experience for mental health nurses and an important part of their role. How mental health nurses respond to and support those who self‐harm can have a significant impact on the outcomes for service users and their intentions to seek help in the future. Repeated self‐harm can be a particularly challenging phenomenon as it is often misunderstood and can have a negative impact on the therapeutic relationship. This qualitative descriptive study aims to explore how mental health nurses understand and work with repeated self‐harm. Nine nurses working in a range of mental health settings within one service participated in semi‐structured interviews which were analysed thematically. Findings are presented in two themes exploring participants’ perceptions and understanding of repeated self‐harm, and the process of learning to work with repeated self‐harm, and are reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Participants reported that nursing practice relating to repeated self‐harm remains largely focused on maintenance of safety and prevention of self‐harm despite the identification that this often does not work. It was accepted that there is sometimes a lack of understanding about the function of self‐harm; however, participants reported understanding increased following specific education about self‐harm. Participants also identified the potential for more empowering and recovery‐orientated responses, including the utilization of harm reduction approaches, to the care of those who repeatedly self‐harm.

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Section: Introductionmentioning

confidence: 99%

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

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“…Staff understood the resulting self-harm and distress as being maintained through unhelpful staff responses but also noticed the resulting distress of having self-harmed. This is reflective of the cycle of self-harm, experience of rejection resulting in shame and guilt and further self-harm described by Rayner & Warne (2015). This study also added the insight of staff's observations of the ways distress management was achieved using medication, other drugs and through sleep (as previously described in Huband & Tantam [2004]).…”

Section: Discussionmentioning

confidence: 69%

How people who self‐harm negotiate the inpatient environment: the mental healthcare workers perspective

Thomas

Haslam

2017

Psychiatric Ment Health Nurs

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Introduction Literature describes self-harm as functional and meaningful. This creates difficulties for service-users detained in an inpatient environment where self-harm is prevented. Aim Mental healthcare staff were interviewed to build on existing evidence of issues with the prevention approach and explore, from a staff perspective, how self-harm prevention impacts on service-users, how they manage distress and how this impacts on staff and their approach to care. Methods Qualitative methods were used to allow unexpected themes to arise. Ten semi-structured interviews were carried out with mental healthcare staff and thematically analysed. Findings and discussion The findings provide new evidence on the benefits and limitations of the inpatient environment for individuals who self-harm. Findings indicate that being unable to self-harm can lead to a continuation of distress and subsequent potentially harmful attempts to manage distress. Staff described experiencing a struggle for control in preventing self-harm, leading to increasingly harmful methods of self-harm. Alternatively some staff were able to support service-users with distress management. We discuss factors influencing which of these 'paths' service-users followed. Implications Considerations for care planning including understanding self-harm, using individualized care planning and attending to barriers are outlined with the ultimate aim of reducing distress and the impact of prevention of self-harm.

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“…The authors of this paper would also add the following educational material to provide a fully integrated physical and psychological social education: exploration of the interpersonal processes for staff when working with people who self-harm (Rayner & Warne 2016;Rayner et al 2005); empathy, therapeutic alliance and communication educational and skills training; and as indicated by Ousey et al (2014): wound care/physical care whilst providing emotional wellbeing support. Education should include ongoing clinical supervision where staff can explore their attitudes and beliefs in a nonthreatening environment.…”

Section: Relevance To Clinical Practicementioning

confidence: 99%

Emergency department nurse's attitudes towards patients who self‐harm: A meta‐analysis

Rayner

Blackburn

Edward

et al. 2018

Int J Mental Health Nurs

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Self‐harm is a major challenge to public health. Emergency department (ED) nurses treat significant proportions of patients with self‐harm injuries, and positive therapeutic patient–nurse interactions are imperative to the physical and psychological outcome of this vulnerable patient group. Research, both nationally and internationally, suggests that treating those with self‐harm injuries is emotionally challenging, and ambivalence, powerlessness, and ineffectiveness are commonly manifested in negative attitudes towards these patients. Following the PRISMA guidelines, this systematic review with meta‐analyses examined the attitudes of ED nurses towards patients who self‐harm, based on currently available evidence. The following databases were searched: CINAHL complete; Medline complete; PsycARTICLES; PsycINFO; The Allied and Complementary Medicine Database; Health Source: Nursing/Academic Edition; PsycEXTRA; and Psychology and Behavioural Sciences Collection. Clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant reports to identify additional studies, were also searched. Five studies were included in the meta‐analysis. The Self‐Harm Antipathy Scale (SHAS) was used as an outcome in two studies appropriate for meta‐analysis. The Attitudes Towards Deliberate Self‐Harm Questionnaire (ADSHQ) scale was used as an outcome in three studies appropriate for meta‐analysis. Results demonstrated limited empathy and negativity towards patients who self‐harm, indicating a requirement for education and supervision of ED staff, where the SHAS or the ADSHQ can be used to monitor attitude change. Self‐harm educational content for ED staff should include areas of knowledge building including explanations and causes of self‐harm; range, forms, and functions of self‐harm; staff responses to self‐harm; assessment, management, and interventions; professional practice issues.

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Interpersonal processes and self‐injury: a qualitative study using Bricolage

Cited by 18 publications

References 35 publications

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

How people who self‐harm negotiate the inpatient environment: the mental healthcare workers perspective

Emergency department nurse's attitudes towards patients who self‐harm: A meta‐analysis

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