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Title: Exploration of psychiatric nurses' attitudes towards service users who self-harm in secure environments
Author: Sandy, Peter Thomas
Awarding Body: Brunel University
Current Institution: Bucks New University
Date of Award: 2011
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The literature is clear that self-harm is a serious and widespread behaviour among people with mental health problems, often causing distress to the individuals involved. This issue rightly causes concern among healthcare professionals, whose role it is to safeguard people with mental health problems. Noted in the literature is an apparent differential perception between professionals and service users of the underlying motives for self-harming behaviours in mental health services. This gulf in perception appears to have an impact on the relationship between service users and healthcare professionals, and the care received by the former. What is less clear from the literature is healthcare professionals` experience of self-harm in secure psychiatric settings. This study attempts to fill this knowledge gap by investigating the attitudes and perceptions of healthcare professionals toward self-harm in secure settings. This research, which adopted a multi-method phenomenological approach, was conducted just over four years. The study was conducted in a range of secure environments within a large mental health Trust in southern England. It involved 25 individual interviews and six focus groups to uncover the perceptions of healthcare professionals toward this phenomenon. The data were analysed using Interpretative Phenomenological Analysis according to the procedure recommended by Smith et al (2009). The chief finding is that healthcare professionals have mixed attitudes towards self-harm, but mainly negative ones, which in the main relate to the impact of self-harm and to limited knowledge and skills. This knowledge and skill deficit has implications for effective care provision and recommendations are made to improve this. Routine education about self-harm should be provided for healthcare professionals in secure settings in order to develop their confidence and competence in care provision and communication. Additionally, formal supervision should focus on self-harm management, and staff meetings conducted for the sharing of ideas about how to address challenges. A range of strategies are used by healthcare professionals to cope with the impact of self-harm. Apart for seeking knowledge, staff meetings and supervision, teamworking and blaming service users approaches were also utilised. This is the first study to investigate self-harm within secure settings using this methodology. Its findings provide much needed information.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available