Clarifying self-harm through evolutionary concept analysis

Abstract

Clarification of the concept self-harm is needed in order to enable research and theory development and facilitate the development and evaluation of medical interventions and nursing care for individuals who self-harm. This study presents such a conceptual analysis. Articles from 1997 to 2007 were sought from the Medline, PubMed, Cinahl, and PsychINFO search engines by entering the search words 'self-harm', 'self-harming', and 'psychiatric care'. 25 medicine and 23 nursing science articles were chosen for inclusion and analysed. Rodgers' evolutionary concept analysis process was used to delineate and clarify the concept's context, surrogate terms, antecedents, attributes, and consequences, as well as to determine implications for further research. Attributes of self-harm may include repetitive injury of mouth or exterior body, that is to say the infliction of physical pain to alleviate mental pain, and time spent self-harming. Antecedents may be gender, mental pain, substance abuse and relational problems. Consequences often include the need for medication and help with altering coping behaviour. Some self-harm patients met with negative attitudes from nurses. Individualized care and treatment is recommended. Accordingly, inter-professional collaboration and postgraduate education is needed in order to provide better care and treatment for self-harm patients. Furthermore, better understanding is needed to help enable health care personnel understand why individuals self-harm. The conceptual analysis presented in this study may be helpful as regards theory development within this still rather unexplored field.

Person‐centred care: clarifying the concept in the context of inpatient psychiatry

“…The evolutionary approach to concept analysis, as described by Rodgers (5,6), does not prescribe quality assessment. Such an amendment has been suggested as a means of further developing the method (47). However, as the purpose of reviewing the literature for this paper was to analyse the use of the concept, a critical evaluation of the quality of the papers included was deemed irrelevant.…”

Mental Health Nurses’ Experiences of Caring for Patients Suffering from Self-Harm

“…Self-harm is an expanding health problem and is in many cases a hidden behavior. Direct self-harm has been described with different terms, including deliberate self-harm, self-injury, attempted suicide, self-mutilation, or parasuicide [ 1 , 2 ]. It is difficult to measure accurately how many people self-harm.…”

“…In the UK it is estimated that self-harm affects one out of every fifteen adolescents [ 4 ]. Self-harm among south Asian women in the UK is higher than among the white population [ 5 ], yet according to one recent study white adolescent females seem to be overrepresented in many self-harm studies [ 2 ].…”

“…The traditional way of caring for self-harm inpatients in acute mental health care is through restrictive actions [ 4 ], such as the removal of knives, razor blades, belts, shoelaces, or lighters, in combination with systematic and rigorous observation [ 2 ]. Another study describes [ 6 ] that the most common interventions for self-harm are verbal deescalation and manual restraint for inpatients in psychiatric wards.…”

Experiences of Help From the Perspective of Finnish People Who Self-Harmed During Adolescence

“…Self-harm is a significant and common universal health problem among adolescents (Hawton et al, 2012;Madge et al, 2008;Skegg, 2005). The term self-harm covers a range of acts and intentions that are usually intended to respond to unbearable tension (Skegg, 2005), and it can be thought of as expressing mental pain (Tofthagen & Fagerstrøm, 2010). The terminology varies, also terms self-injury, selfmutilation, para-suicide, deliberate self-harm, non-suicidal self-injury, self-poisoning and suicide attempt and suicide are used in scientific research (Muehlenkamp et al, 2012;Skegg, 2005;Tofthagen & Fagerstrøm, 2010).…”