Search

Background Self-harm is a widespread behaviour among people with mental health problems. Although guidance on how to manage self-harm is offered, it is still a behaviour that is misunderstood by many nurses. Such misunderstanding is generally attributed to the perceived motives for self-harm and lack of specialized education to manage the behaviour. As a consequence, the care provided is usually inadequate and inappropriate. Yet, research concerning nurses' reasons of users' self-harming behaviours is limited. Aim This paper reports on a study that explores nurses' explanations of the motives for self-harm in a secure adolescent unit in England. Methods The study utilized a phenomenological methodology with semi-structured individual interviews ( n = 25). The data were analysed thematically using interpretative phenomenological analysis. Results The findings indicate that the behaviour of self-harm has multiple motives. Examples of these include affect regulation, coping with distress, averting death, regaining control and attention seeking. Discussion Self-harm is a complex behaviour commonly experienced in secure environments. Nurses assume that users who self-harm are motivated by a desire to seek attention and manipulate others. Users may find these beliefs humiliating. Such feelings may increase users' risks for further self-harm. Most adolescents who self-harm experience unbearable emotions because of their past sexual abusive encounters. They self-harm to regulate these emotions. These affect regulatory functions may act as reinforcers of self-harming behaviours. Conclusions Improved understanding of self-harm and its motives may result in improved nurse-user relationships and thus safer and more effective care provision. [ABSTRACT FROM AUTHOR]

Richter M.S., Mill J., Muller C.E., Kahwa E., Etowa J., Dawkins P. & Hepburn C. (2013) Nurses' engagement in AIDS policy development. International Nursing Review 60, 52-58 Background: A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care . One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. Methods: A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Findings: Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. Conclusions: The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level. [ABSTRACT FROM AUTHOR]

THUPAYAGALE-TSHWENEAGAE G. & MOKOMANE Z. (2013) Needs of South African adolescents orphaned by AIDS: evidence from photography and photo-elicitation. International Nursing Review 60, 88-95 Background: Available evidence shows that over half of all orphans under the age of 18 years are adolescents aged between 12 and 17 years. Despite this, the needs of adolescents orphaned by AIDS are seldom recognized or adequately addressed in policy and programmes. Instead, the focus tends to be on the needs of orphans and vulnerable children. However, there are several factors that render adolescent-specific programmes important. Purpose: Using data from an urban area in South Africa, this paper illuminates the needs of adolescents orphaned by AIDS. Method: A phenomenological study using photography and photo-elicitation was used with 15 adolescents aged between 14 and 18 years orphaned by AIDS. Results: The study participants captured different objects that were grouped under six broad themes: symbols of death, nature, people, past life, children and hope. The photographic component of the study was followed by photo-elicitation. From the meanings the adolescents made of their images, the needs of adolescents orphaned by AIDS were discerned as love, care and acceptance, safety, and security and support. Conclusion: Overall, the results showed that adolescents orphaned by AIDS want to feel secure, safe, wanted by caregivers and to feel that caregivers support them in their grieving journey. [ABSTRACT FROM AUTHOR]