Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-14T09:34:50.041Z Has data issue: false hasContentIssue false

Nursing Staff Knowledge and Attitudes Towards Deliberate Self-Harm in Adults and Adolescents in an Inpatient Setting

Published online by Cambridge University Press:  27 April 2009

Malcolm Wheatley*
Affiliation:
St. Andrew's Healthcare, Northampton, UK
Hannah Austin-Payne
Affiliation:
Coventry University, UK
*
Reprint requests to Malcolm Wheatley, St. Andrew's Healthcare, Billing Road, Northampton NN1 5DG, UK. E-mail: [email protected]

Abstract

Background: This paper investigates the relationship between care staff perceptions' of self-harm behaviours presented by adult and adolescent inpatients and the emotional responses and helping behaviours of the staff. Method: Seventy-six nursing staff participated, including qualified and unqualified staff, who worked in either adolescent or adult secure inpatient settings within a single organization. Participants completed vignette, knowledge, and attitudes questionnaires, related to working with patients who display deliberate self-harm. Results: Further support was found for attributional theories suggesting that views on deliberate self-harm are linked to propensity to help, and that emotional responses can be a mediating factor. Staff who reported feeling more negative about patients who self-harm reported more worry about working with this patient group. Unqualified nursing staff reported more negativity and worry than qualified staff. Neither gender nor length of work experience was found to be significant factors. Conclusions: These findings indicate that training and support should be aimed at helping nursing staff, particularly unqualified staff working in inpatient settings where self-harm is frequent, feel more positive and less concerned about working with patients who self-harm. Such needs of unqualified nursing staff have not been highlighted in previous research.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Crawford, T., Geraghty, W., Street, K. and Simonoff, E. (2003). Staff knowledge and attitudes towards deliberate self-harm in adolescents. Journal of Adolescence, 26, 619629.Google Scholar
Dagnan, D., Trower, P. and Smith, R. (1998). Care staff responses to people with learning disabilities and challenging behaviour: a cognitive-emotional analysis. British Journal of Clinical Psychology, 37, 5968.CrossRefGoogle ScholarPubMed
DiClemente, R. J., Ponton, L. E. and Hartley, D. (1991). Prevalence and correlates of cutting behaviour: risk for HIV transmission. Journal of the American Academy of Child and Adolescent Psychiatry, 135, 735739.Google Scholar
Faul, F., Erdfelder, E., Lang, A. G. and Buchner, A. (2007). G*POWER 3: a flexible statistical power analysis program for the social, behavioural, and biomedical sciences. Behaviour Research Methods, 39, 175191.CrossRefGoogle ScholarPubMed
Friedman, T., Newton, C., Coggan, C., Hooley, S., Patel, R., Pickard, M. and Mitchell, A. J. (2006). Predictors of A&E staff attitudes to self-harm patients who use self-laceration: influence of previous training and experience. Journal of Psychosomatic Research, 60, 273277.CrossRefGoogle Scholar
Ghodse, A. (1978). The attitudes of casualty staff and ambulance personnel towards patients who take drug overdoses. Social Science and Medicine, 12, 341346.Google Scholar
Ghodse, A. H., Ghaffari, K., Vaman Bhat, A., Galea, A. and Hayat Qureshi, V. (1986). Attitudes of heath care professionals towards patients who take overdoses. International Journal of Social Psychiatry, 32, 5863.CrossRefGoogle Scholar
Gough, K. and Hawkins, A. (2000). Staff attitudes to self-harm and its management in a forensic psychiatric service. The British Journal of Forensic Practice, 2, 2228.CrossRefGoogle Scholar
Hawton, K. (1992). Suicide and attempted suicide. InPaykel, E. S. (Ed.),Handbook of Affective Disorders (2nd edn). New York: Guilford Press.Google Scholar
Hawton, K. and Fagg, J. (1992). Trends in deliberate self-poisoning and self-injury in Oxford, 1976–90. British Medical Journal, 304, 14091411.CrossRefGoogle ScholarPubMed
Hawton, K., Townsend, E., Deeks, J., Appleby, L., Gunnell, D., Bennewith, O. and Cooper, J. (2001). Effects of legislation restricting pack sizes of paracetamol and salicylate in self poisoning in the United Kingdom: before and after study. British Medical Journal, 322, 12031207.CrossRefGoogle ScholarPubMed
Horrocks, J. and House, A. (2002). Self-poisoning and self-injury in adults. Clinical Medicine, 2, 509512.Google Scholar
Huband, N. and Tantam, D. (2000). Attitudes to self injury within a group of mental health staff. British Journal of Medical Psychology, 73, 495504.Google Scholar
James, M. and Warner, S. (2005). Coping with their lives -3 women, learning disabilities, self-harm and the secure unit: a Q-methodological study. British Journal of Learning Disabilities, 33, 120127.Google Scholar
Mackay, N. and Barrowclough, C. (2005). Accident and Emergency staff's perceptions of deliberate self-harm: attributions, emotions and willingness to help. British Journal of Clinical Psychology, 44, 255267.CrossRefGoogle ScholarPubMed
McAllister, M., Creedy, D., Moyle, W. and Farrugia, C. (2002). Nurses' attitudes towards clients who self-harm. Journal of Advanced Nursing, 40, 578586.Google Scholar
McCann, T., Clark, E., McConnachie, S. and Harvey, I. (2006). Accident and emergency nurses' attitudes towards patients who self-harm. Accident and Emergency Nursing, 14, 48–10.Google Scholar
Moores, B. and Grant, G. W. B. (1976). Nurses' expectations for accomplishments of mentally retarded patients. American Journal of Mental Deficiency, 80, 644649.Google ScholarPubMed
National Institute for Health and Clinical Excellence (NICE) (2004, July). Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care (Online). Available: http://www.bps.org.uk/publications/core/self-harm-guidelines/self-harmhome.cfmGoogle Scholar
Penn, J. V., Esposito, C. L., Schaeffer, L. E., Fritz, G. K. and Spirito, A. (2003). Suicide attempts and self-mutilative behaviour in a juvenile correctional facility. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 114.Google Scholar
Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I. and Seligman, M. E. P. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6, 287299.CrossRefGoogle Scholar
Sansone, R. A., Songer, D. A. and Miller, K. A. (2005). Childhood abuse, mental healthcare utilisation, self-harm behaviour, and multiple psychiatric diagnoses among inpatients with and without a borderline diagnosis. Comprehensive Psychiatry, 46, 117120.CrossRefGoogle ScholarPubMed
Sansone, R. A., Songer, D. A. and Miller, K. A. (2007). A naturalistic study of the relationship between self-harm behaviours and Axis I diagnostic groupings among inpatients. International Journal of Psychiatry in Clinical Practice, 11, 7375.CrossRefGoogle ScholarPubMed
Sharrock, R., Day, A., Qazi, P. and Brewin, C. R. (1990). Explanations by professional staff, optimism and helping behaviour: an application of attribution theory. Psychological Medicine, 20, 849855.CrossRefGoogle ScholarPubMed
Sidley, G., and Renton, J. (1996). General nurses' attitudes to patients who self-harm. Nursing Standard, 10, 3236.CrossRefGoogle ScholarPubMed
SPSS Inc. (2006). SPSS 15.0 for Windows. Chicago, USA.Google Scholar
Thomson, L. D. G., Bogue, J. P., Humphreys, M. S. and Johnstone, E. C. (2001). A survey of female patients in high-security psychiatric care in Scotland. Criminal Behaviour and Mental Health, 11, 8693.CrossRefGoogle ScholarPubMed
Weiner, B. (1980). A cognitive (attribution)-emotion-action model of helping behaviour: an analysis of judgements of help giving. Journal of Personality and Social Psychology, 39, 186200.CrossRefGoogle Scholar
Weiner, B. (1986). Attributional Theory of Motivation and Emotion. New York: Springer-Verlag.CrossRefGoogle Scholar
White, J., Leggett, J. and Beech, A. (1999). The incidence of self-harming behaviour of a medium-secure psychiatric hospital. Journal of Forensic Psychiatry, 10, 5968.Google Scholar
Submit a response

Comments

No Comments have been published for this article.