Nurses' attitudes towards self‐harm: a literature review

Abstract

People who self-harm experience many problems and needs related to management of emotional and practical stress. A positive attitude among nurses is especially important given the close contact they have with people who self-harm. This article is based on a review of the literature. It includes articles that concern both general and mental health nurses who work in various healthcare settings (e.g. acute inpatients wards, community mental health, emergency departments and medical admission units). The literature shows that negative attitudes towards self-harm are common among nurses. It remains unclear how nurses' age, work experience and gender influence their attitudes. The setting in which nurses work appears to influence their attitude, as does their level of qualification. For example, mental health nurses appear to have more positive attitudes than general nurses. Nurses' attitudes can be improved with the help of education comprising reflective and interactive elements. Supervision and support from colleagues appear to be especially important for mental health nurses. Self-harm is a growing health problem. Nurses in a variety of healthcare settings play a central role in the care of people who self-harm. Their professional attitudes towards these people are essential for high-quality care. This review aims to develop insight into nurses' attitudes towards self-harm as they exist in contemporary nursing practice. A literature search was conducted in four databases, and a total of 15 relevant articles were found. This review indicates that negative attitudes towards self-harm are common among nurses. The influence of nurses' age, gender and work experience remains unclear. Healthcare setting and qualification level appear to be influencing factors. Education can have a positive influence on nurses' attitudes towards self-harm, especially when it includes reflective and interactive components. It is demonstrated in this review that a major change is needed regarding nurses' attitudes. To realize this change, nurses need to be trained and educated adequately concerning self-harm. They need time and resources to build a therapeutic relationship with people who harm themselves so they can offer high-quality care for this vulnerable group.

Motivations for adolescent self‐harm and the implications for mental health nurses

“…, Karman et al . ). Studies find that healthcare professionals appear to evaluate the reason for a self‐harm act and hold more favourable attitudes towards those they believe to have a ‘genuine’ reason compared to those whom they deem responsible for their self‐harm (Doyle et al .…”

An exploration of predictors of children's nurses’ attitudes, knowledge, confidence and clinical behavioural intentions towards children and young people who self‐harm

“…Their results showed that overall, nurses had sympathetic attitudes towards patients who self‐harm, including both professional and lay conceptualisations of deliberate self‐harm. There is some evidence that the setting in which nurses work and their level of qualification might influence their attitudes (Karman et al., ).…”

Attitudes towards suicidal behaviour and associated factors among nursing professionals: A quantitative study

“…Professional training has been found to have a strong and positive association with favourable attitudes (Botega et al., , ; Bott, de Araujo, Costa, & Machado, ; Kishi et al., ; Moraes, Magrini, Zanetti, dos Santos, & Vedana, ; Norheim, Grimholt, Loskutova, & Ekeberg, ; Ramberg, Di Lucca, & Hadlaczky, ; da Silva Cais, da Silveira, Stefanello, & Botega, ). However, there are little available data regarding the subject, and the relationships between attitudes towards suicide and many factors remain unclear (Karman et al., ; Kelly et al., ; McCarthy & Gijbels, ; Santos et al., ). Furthermore, few studies have been conducted in Latin America, and studies that have previously assessed attitudes towards suicidal behaviour in Brazil have not assessed the perspectives of the emergency nursing staff (Botega et al., , ; Bott et al., ; Moraes et al., ; da Silva Cais et al., ) who may play a singular role in suicide prevention.…”