Online Journal Club Session 1

The first Online Journal Club session deals with an important issue, which is not well understood:  Self-harm.  The research study and commentary explore self-harm episodes within inpatient psychiatric services.

This study is very important because it is the first to focus solely on inpatient self-harm in a national healthcare system. The commentary offers insight into aspects of the article, specifically the reaction of nursing staff to patients who self-harm. The commentary indicated that non-suicidal self-harm is often seen as manipulative or attention-seeking by staff, which results in negative attitudes toward patients.  In contrast, the researchers found that the majority of episodes of self-harm were conducted in private and were not related to attention seeking.

The recommendation is that the reasons for self-harm should be explored and, at the same time, strategies should be implemented by nurses to maintain empathetic and therapeutic relationships with patients.

What is your reaction to this research?  Will it change the way you view patients, both those in psychiatry and those receiving care for other issues?  Tell us what you think.

You may review the podcast from this link: http://bit.ly/17zAwAb

Article:  James K, Stewart D, Wright S, et al. Self harm in adult inpatient psychiatric care: a national study of incident reports in the UK. Int J Nurs Stud 2012; 49: 1212– 19

Abstract:  http://www.ncbi.nlm.nih.gov/pubmed/22609137

Commentary:  http://bit.ly/10l05iK

Comments about the topic can be posted on this blog, or using twitter at #ebnjc.

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  • Alison Twycross

    This is an important study as it provides new information about self-harming in in-patient psychiatric hospitals. How do the results reflect people’s experiences of working with this client group?

    • nobleh

      I haven’t worked directly with this group but this study gives me insight into a complex emotional issue which requires sympathetic management.

  • rheale

    My experience is with patients in community settings, however, the study gives me a better understanding of those who self harm. Like the hospital staff in this study, I always thought that the self-harm behaviour was attention seeking. The article helped me to understand that it is a private behaviour, but with visible outcomes. I’m sure that this understanding will change my approach to the care of these patients, for the better.

    • Alison Twycross

      Thanks for sharing this. If you listen to the podcast you can listen to Peter’s (the commentary writer’s) take on the situation.

  • Alison Twycross

    What do people think about the methodology used? What are the advantages of extracting data from a national database?

  • DorothyForbes20

    Further evidence of using a person-centered approach – get to know your patients.

  • Alison Twycross

    Listen to the podcast (http://bit.ly/1aR6Q05) – more than 34,000 suicides a year in the USA. This research needs repeating in other settings.

  • rheale

    The antecedents for self-harm are what interest me. The “why” is important if we are make a difference. Knowing this may give insight into treatment and resources for patients with self harm tendencies. In other words, prevention.

  • Jo Smith

    Self-harm is a complex and challenging area of work for health professionals. Associations with attention-seeking behaviour can results in health professionals having a negative attitude towards people who self-harm. It is vital that personal perspectives and attitudes must be explored, perhaps through clinical supervisor, acknowledged and consider in line with professional codes, for health professionals working with people who self-harm. An increased evidence-base is essential to underpin the support and care of people who self-harm. This month’s featured commentary, pod cast and blog are invaluable for raising this important area of practice
    Jo Smith
    Tweet me @josmith175