Darbo tikslas: ištirti linkusių ir nelinkusių savęs žaloti įkalintų asmenų nerimo, depresiškumo įverčių skirtumus ir tarpusavio sąsajas su stresogeninių situacijų įveikos strategijomis. Tiriamieji: šiame tyrime, vykusiam nuo 2008 – 02 – 18 iki 2008 – 10 – 01, dalyvavo 256 laisvės atėmimo vietose esantys asmenys, suskirstyti į dvi – tiriamąją ir lyginamąją – grupes. Iš jų tyrime dalyvavo 81 asmuo, įtrauktas į laisvės atėmimo vietos nuteistųjų ir suimtųjų, priklausančių didelės rizikos grupei dėl savęs žalojimosi ar bandymo nusižudyti apskaitos žurnalą, kuriems paskirta sustiprinta individuali priežiūra – minėti asmenys sudaro tiriamąją grupę. Lyginamąją grupę sudarė 176 laisvės atėmimo vietose esantys neįtraukti į šį apskaitos žurnalą asmenys. Tyrimui naudotos HAD (Hospital Anxiety and Depression), BDI (Beck Depression Inventary), COPE metodikos. Išvados: nustatyta, jog linkę save žaloti yra jauni asmenys (amžiaus vidurkis – 30 m.), turintys žemesnį išsilavinimą, suimti ar atliekantys bausmę už sunkius, smurtinius nusikaltimus, laikantys save priklausomais nuo alkoholio, narkotinių medžiagų. Linkusių save žaloti įkalintų asmenų grupėje nerimo, depresiškumo įverčiai lyginant su įkalintais, bet nežalojusiais savęs asmenimis – aukštesni. Įvertinus tik linkusių save žaloti asmenų grupės depresiškumo, nerimo įverčių išreikštumą pagal laisvės atėmimo vietą nustatyta, jog suimtų asmenų grupėje nerimo, depresiškumo (tik BDI) įverčiai aukštesni nei nuteistų asmenų grupėje. Tyrime... [toliau žr. visą tekstą] / The aim of the research. To survey differences in evaluations of anxiety and depression and links with strategies used to cope with stressful situations of persons in confinement who are tended to injure themselves and those who are not.The object of the research: 256 persons in confinement took part in the research. They were divided into two groups: analyzed and comparative groups. The research was started on the 18th of February, 2008 and ended on the 1st of October, 2008. Analyzed group was made out of 81 person who were tended to injure themselves (all of them belonged to the group of persons in confinement with the higher risk due to the disposition to injure or kill themselves, and were under reinforced supervision). Comparative group was made out of 176 persons in confinement who didn‘t belong to the group with the higher risk due to the disposition to injure or kill themselves. Methods of research were HAD (Hospital Anxiety and Depression), BDI (Beck Depression Inventory), COPE methods. Conclusions. The research showed that persons who are tended to kill or injure themselves are young (~ 30 years old), with lower education, arrested or sentenced for violent crimes and those who think that are dependant on alcohol or drugs. Evaluations of anxiety and depression are higher in the group of persons in confinement who are tended to injure themselves. The results of the research showed that evaluations of anxiety and depression (only BDI) are higher in the group of... [to full text]

For over a decade, suicides of young people have been a very important public health concern. The number of suicides among the school-aged children varies from 20 to 33 per annum, whereas suicide as the cause of death is number three on the list of causes. Research carried out in various countries provide clear evidence that one of the most threatening signs of the possible suicidal behaviour is self-harm or attempted suicide at an early age. Therefore, in-depth knowledge of the risk factors for deliberate self-harm is very important not only for scientific reasons, but for the prevention of suicides of young people. The aim of dissertation is to research social and psychological peculiarities of deliberate self-harm of 15-17 year old Lithuanian pupils. In order to achieve the aim, the following objectives were set: 1. To assess distribution of pupils’ deliberate self-harm, types of self-harm, and socio-demographic irregularities. 2. To disclose subjective reasons for deliberate self-harm of pupils. 3. To analyse the relationship between stressful life experience and pupils’ deliberate self-harm. 4. To identify the importance of smoking, alcohol, and drug abuse to deliberate self-harm. 5. To investigate the relationship between the pupils’ deliberate self-harm and subjective indices of psychic health and general condition. 6. To assess the need for help to pupils who deliberately harm themselves. / Jaunų žmonių savižudybės jau daugiau kaip dešimtmetį išlieka labai svarbia visuomenės sveikatos problema. Mokyklinio amžiaus vaikų savižudybių skaičius per metus svyruoja nuo 20 iki 33, o savižudybė pagal dažnį yra trečioje vietoje mirties priežasčių sąraše. Įvairiose šalyse atlikti tyrimai pateikia neabejotinų įrodymų, jog vienas grėsmingiausių galimo savižudiško elgesio rizikos ženklų yra sąmoningas savęs žalojimas ar bandymai žudytis jauname amžiuje. Todėl gilesnis sąmoningo savęs žalojimo rizikos veiksnių pažinimas yra labai svarbus ne tik mokslo, bet jaunų žmonių savižudybių prevencijos požiūriu. Disertacinio darbo tikslas — ištirti sąmoningai save žalojančių 15–17 metų Lietuvos moksleivių socialinius bei psichologinius ypatumus. Tikslui pasiekti iškelti šie uždaviniai: 1. Įvertinti moksleivių sąmoningo savęs žalojimo paplitimą, būdus bei jų sociodemografinius netolygumus. 2. Atskleisti subjektyvias moksleivių sąmoningo savęs žalojimo priežastis. 3. Išanalizuoti ryšius tarp stresą sukeliančios gyvenimo patirties ir moksleivių sąmoningo savęs žalojimo. 4. Nustatyti rūkymo, alkoholio bei narkotikų vartojimo reikšmę moksleivių sąmoningam savęs žalojimui. 5. Išnagrinėti moksleivių sąmoningo savęs žalojimo, subjektyvių psichikos sveikatos bei savijautos rodiklių sąsajas. 6. Įvertinti save žalojančių moksleivių pagalbos poreikius.

<p>Background: The purpose of the present study was to investigate the prevalence and characteristics of deliberate self-harm in a Swedish University population.</p><p>Method: A random sample of first year students at University of Kalmar was invited to participate in an Internet-based survey in the autumn of 2007. A total of 139 (53,1 %) completed the anonymous survey.</p><p>Results: The results showed that 25,2 % (n=35) of the students reported having engaged in some kind of deliberate self-harm at least once, and deliberate self-harm was endorsed by 7,9 % within the past year. The most frequently procedures to self-harm were to tear, carve or pinch self, cutting skin and hitting self on purpose. 37,1 % reported that they had told no one about their self-injurious behaviors and 36,4 % significantly reported that they had no one they trusted and who they could talk to if they were concerned about something. Students with self-injurious behavior were also more likely to report a history of emotional, sexual and/or physical abuse, alcohol and drug use, cut classes and questioning their sexual orientation.</p><p>Conclusions: Findings suggest that self-harm is associated with risk factors and that self-injury is not only associated with adolescence but also with adulthood. It is therefore important to continue studies in both populations.</p>

Bakgrund: Självskadebeteende är ett symtom på psykisk ohälsa som sedan millennieskiftet uppmärksammats i allt högre utsträckning. Den första kontakten med vården personer med självskadebeteende tar sker ofta via den somatiska akutsjukvården. Patienter vittnar om negativa upplevelser i mötet med dessa vårdinstanser. Det är därför av värde att öka kunskapen om hur sjuksköterskor upplever mötet med patienter med självskadebeteende. Syfte: Syftet med litteraturöversikten var att beskriva sjuksköterskors upplevelser av att möta patienter med självskadebeteende inom somatisk akutsjukvård. Metod: Studien genomfördes som en litteraturöversikt där 15 vetenskapliga artiklar söktes via databaserna PubMed, CINAHL, PsycINFO och Web of Science. Artiklarna kvalitetsgranskades, analyserades och sammanställdes till ett resultat. Resultat: Av resultatet har framgått tre huvudkategorier vilka var: Sjuksköterskans tankar och känslor; Kompetens och kunskap; Faktorer som påverkar mötet och vården. Slutsats: Resultatet visade att sjuksköterskor inom somatisk akutsjukvård erfor både positiva och negativa upplevelser i mötet med patienter med självskadebeteende vilka frammanade olika känslor och tankar hos sjuksköterskor. Gemensamt för studierna var att sjuksköterskor uppgav att de hade bristande kompetens och kunskap i samband med omvårdnaden av dessa patienter. / Background: Deliberate self-harm is a symptom of mental illness that ever since the turn of the millennium has been increasingly highlighted. The first contact with healthcare a person with deliberate self-harm often takes place via the somatic emergency medical care. Patients testify to negative experiences in the meeting with these care instances. Therefore, it may be useful to investigate how nurses perceive the meeting with patients with deliberate self-harm. Aim: The aim of the literature review was to describe nurses’ experiences of meeting patients with deliberate self-harm in somatic emergency medical care. Method: The study was conducted as a literature review where 15 scientific articles were sought via the databases PubMed, CINAHL, PsycINFO and Web of Science. The articles were quality-reviewed, analyzed and compiled into a result. Results: In the process of describing nurses’ experiences, three main categories emerged which were: The nurse's thoughts and feelings; Competence and knowledge; Factors that affect the meeting and care. Conclusion: The result showed that nurses in somatic emergency medical care had both positive and negative experiences in the meeting with patients with deliberate self-harm which evoked different feelings and thoughts among nurses. Common to the studies was that nurses stated that they had a lack of competence and knowledge about this patient group.

Bakgrund: Självskadebeteende ter sig olika från person till person. Vissa har en underliggande diagnos som gör att de skadar sig själva, andra har yttre påfrestningar som gör att de börjar skada sig själva. Det anses många gånger vara ett rop på hjälp, att de har svårt att hantera svåra känslor. Mötet mellan dessa personer och omvårdnadspersonalen är uppbyggt av kommunikation mellan dessa personers energier och känslor. Då en upplevelse är olika beroende på vem som upplever den. Syfte: Syftet var att belysa hur personer med självskadebeteende upplever bemötandet av omvårdnadspersonal på sjukhus. Metod: Litteraturstudien baseras på elva artiklar. En induktiv analys användes, vilket resulterade i fem kategorier. Dessa var upplevelse av omvårdnadspersonalens okunskap, upplevelse av skuld och skam, upplevelse av omvårdnadspersonalens oförståelse, upplevelse av att vara utan själ samt upplevelse av att få tillbaka sin själ. Resultat: Resultatet baseras på både positiva samt negativa upplevelser av omvårdnadspersonalens bemötande. Det framkom i resultatet att det handlade mest om en okunskap från omvårdnadspersonalen, som sedan bidrog till att personerna med självskadebeteende upplevde skuld och skam samt vara utan själ. Dock fanns det en viss del som visade att omvårdnadspersonal som behandlade dessa personer med respekt och medkänsla gav personerna med självskadebeteende upplevelse av att de hade en själ. Diskussion: Personer med självskadebeteende bör få ett bra bemötande oavsett var de befinner sig. Våra huvudfynd visar hur mycket bemötande påverkar dessa personerna samt hur och när de söker vård.

Abstract Patients with acute drug poisonings are common in emergency departments and hospitals. Patients typically ingest medical products, most commonly psychotropic drugs that lead to intoxication. The outcome is usually good and hospital stays are short, even among patients requiring intensive care. Complications such as aspiration pneumonia can prolong hospital stays. Acute mortality is low (usually less than 5%) but repetition of self-harm is common and long-term mortality is high. The aim of this study was to evaluate the outcome of drug poisoned patients and the factors associated with unfavourable outcome, including morbidity, length of intensive care unit (ICU) and hospital stays, repetition of drug poisonings, and mortality. The study population consisted of patients treated in Oulu University Hospital due to acute drug poisoning between 1985–2006 and drug poisoned patients in the data base of the Finnish Consortium intensive Care Data. In the first part of the study 276 hospitalised self-poisoned adolescents were examined retrospectively from the patient records for acute contributing risk factors before the intake. Patients with such risk factors had higher rates of depression, non-ethanol poisonings and repetition of self-poisoning within one year. The second part of the study included 257 acute drug-poisoned adult patients requiring intensive care. The factors associated to aspiration pneumonia were evaluated retrospectively. Of these, 28.4% had aspiration pneumonia. Pre-hospital intubation of the comatose patients was associated with lower number of aspiration pneumonias. The third study evaluated 2755 drug-poisoned patients requiring intensive care for risk factors for prolonged ICU length of stay (LOS) using national intensive care database. Factors associated with prolonged stay were respiratory failure, renal dysfunction and lowered platelet count on admission. The hospital mortality in these studies ranged from 0 to 1.6%. The fourth study evaluated the long-term mortality and causes of deaths of 3709 patients admitted to Oulu University Hospital due to acute drug poisoning between 1985 and 2000. The all-cause mortality was recorded at the end 2009 and patients were compared to age- and sex-matched controls. Mortality among the study population was 30.6% compared to 13.6% for the controls. In conclusion, patients admitted to hospital due to acute drug poisoning have good short-term outcomes. Factors associated with prolonged ICU LOS were aspiration pneumonia, respiratory failure on admission, lowered platelet count on admission and renal dysfunction on admission. Impulsive self-poisonings among adolescents are associated with psychopathology and repetitions. Patients with acute drug poisonings have high long-term mortality. / Tiivistelmä Myrkytyspotilaat ovat yleinen potilasryhmä päivystyksissä ja sairaaloissa. Sairaalahoitoisen, akuutin lääkeainemyrkytyksen ennuste on hyvä ja jopa tehohoitoa vaativat potilaat selviävät lyhyellä sairaalahoitojaksolla. Komplikaatiot, kuten mahan sisällön hengitysteihin joutumisesta aiheutuva keuhkokuume (aspiraatiokeuhkokuume) pitkittävät hoitoa. Kuolleisuus hoitojakson aikana on yleensä alle 5&#160;%, mutta pitkäaikaiskuolleisuus näillä potilailla on merkittävä. Tutkimuksen tarkoituksena oli selvittää akuutin lääkeainemyrkytyspotilaan ennustetta ja ennusteeseen vaikuttavia tekijöitä. Ensimmäisessä osatyössä tutkittiin 276 nuoren myrkytyspotilaan myrkytystapahtumaan vaikuttaneita akuutteja riskitekijöitä. Potilaat, joilla oli riskitekijöitä, olivat useammin masentuneita ja heillä oli enemmän uusintakäyntejä myrkytysten vuoksi vuoden sisällä. Toisessa osatyössä selvitettiin aspiraatiokeuhkokuumeen yleisyyttä 257 tehohoitoa tarvinneella lääkemyrkytyspotilaalla. Potilaista 28,4&#160;% sai aspiraatiokeuhkokuumeen. Ennen sairaalaan tuloa suoritettu hengitysteiden varmistaminen hengitysputkella (intubaatio) pienensi aspiraatiokeuhkokuumeen riskiä merkittävästi verrattuna niihin, jotka intuboitiin vasta sairaalassa. Kolmannessa osatyössä tutkittiin 2755 myrkytyspotilaan riskitekijöitä pitkittyneeseen tehohoitoon. Hengitysvajaus, munuaisten toiminnan vajaus ja matala veren verihiutalearvo sairaalaan tullessa olivat pitkittyneen hoidon riskitekijöitä. Kuolleisuus hoitojakson aikana oli näissä kolmessa tutkimuksessa 0–1.6&#160;%. Neljännessä osatyössä tutkittiin 1985–2000 OYS:ssa hoidettujen myrkytyspotilaiden pitkäaikaisennustetta ja kuolinsyitä. Kuolleisuus vuoden 2009 loppuun mennessä oli 3709 potilaan joukossa 30,4&#160;%, kun vastaava kuolleisuus ikä- ja sukupuolivakioitujen verrokkien keskuudessa oli 13,6&#160;%. Kaikki kuolinsyyt olivat yleisempiä tutkimusjoukossa verrattuna verrokkeihin. Yhteenvetona voidaan todeta että akuuttien myrkytyspotilaiden ennuste on hyvä akuutissa vaiheessa. Aspiraatiokeuhkokuume on yleinen komplikaatio myrkytyspotilailla ja se on osittain vältettävissä hengitystien varhaisella varmistamisella. Impulsiivinen käytös nuorella myrkytyspotilaalla assosioituu psykopatologiaan ja uusintamyrkytyksiin. Myrkytyspotilaan pitkäaikaisennuste on huono. Kuolleisuus ennaltaehkäistäviin syihin, kuten itsemurhiin sekä sydän- ja verisuonitauteihin, on huomattava.

Bakgrund: Självskadebeteende är ett växande samhällsproblem. Ibland brister sjuksköterskors bemötande av patienter med självskadebeteende inom somatisk vård. Problem: Patienter med självskadebeteende som vårdas inom somatisk vård riskerar att inte få den vårdrelation med sjuksköterskan som det finns behov av. Syfte: Att utforska sjuksköterskors erfarenheter gällande deras vårdrelation med patienter med självskadebeteende. Metod: Empirisk intervjustudie med fem sjuksköterskor inom en somatisk vårdavdelning på ett länssjukhus i Sverige. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Innehållsanalysen resulterade i två kategorier, betydelsen av sjuksköterskornas bemötande i vårdrelationen med patienter med självskadebeteende samt brist på tillit i vårdrelationen med patienter med självskadebeteende. Sex underkategorier identifierades utifrån dessa två kategorier. I sjuksköterskornas bemötande ansågs det avgörande för vårdrelationens utveckling att bekräfta patienten, visa intresse och skapa förtroende. Brist på tillit i vårdrelationen skapade känslor som misstro, osäkerhet och brist på motivation hos sjuksköterskorna. Slutsats: Sjuksköterskornas bemötande i vårdrelationen med patienter med självskadebeteende är av betydelse för hur vårdrelationen utvecklas. Tillit är en väsentlig del i vårdrelationen mellan sjuksköterskor och patienter med självskadebeteende och det är av betydelse för vårdrelationen att den är ömsesidig. / Background: Deliberate self-harm has become an increasing problem in society. Nurses sometimes express negative attitudes towards patients who self-harm in somatic care settings. Problem: While being treated in somatic care settings, a patient who self-harm may not get the caring relationship with the nurse that is needed. Aim: To explore nurses’ experiences regarding their caring relationship with patients who self-harm. Method: Interview with five nurses within a somatic nursing ward in Sweden. The material was analyzed with qualitative content analysis. Result: The content analysis resulted in two categories, the meaning of nurses’ attitude in the caring relationship with patients who self-harm and lack of trust in the caring relationship between nurses and patients who self-harm. Six subcategories were identified based on these two categories. Within the nurses’ attitude it was considered crucial for the development of the caring relationship to acknowledge the patient, show interest, and create reliance. Lack of trust in the caring relationship brought feelings of mistrust, insecurity and lack of motivation. Conclusions: Nurses’ attitude in the caring relationship with patients who self-harm has meaning in developing the caring relationship, trust is essential between nurses and patients who self-harm and it is important that the trust is mutual.

Repetitive self-mutilation (RSM) has become increasingly prevalent among adolescents. Empirical research has pinpointed several correlates of this behavior, but the initiation and maintenance of RSM among adolescents are not well understood. The experiential avoidance model (EAM) proposes that self-mutilation is a behavior that allows for the avoidance or alteration of unwanted internal experiences, and that it is negatively reinforced with repetition. The current study explored the usefulness of the EAM as an explanatory theory for adolescent RSM, with the additional incorporation of issues of social context. Adolescents (N = 211) from three school-based samples completed self-report questionnaires. One-third of students reported at least one incident of purposeful, non-suicidal self-mutilation and 16% had engaged in self-mutilation repeatedly within the past 6 months. Both regression and group analyses indicated that adolescents who engage in RSM report greater psychological distress, a greater incidence of functionally equivalent behaviors, and greater exposure to self-mutilation among peers and/or in the media, when compared to their counterparts who have not engaged in RSM. Suicidal ideation/behaviors were consistently the strongest predictors of current self-mutilation behaviors. Clinical implications, limitations, and suggestions for future research are discussed.

The current study is motivated by the relative lack of research on the contagion of deliberate self-harm, research on self-harm among adolescents in children's homes, as well as South African research on self-harm. In this study, I explore three aspects concerning deliberate self-harm in the South African context: The perceptions of adolescents in children's homes concerning the possible contagion of self-harm; the frequency, methods, duration and severity of self-harm among adolescents in children's homes; and lastly, the motivations of adolescent self-harm in children's homes. I make use of both quantitative measures, being the Deliberate Self-Harm Inventory (DSHI) developed by Gratz (2001) and the Functional Assessment of Self-Mutilation (FASM) developed by Lloyd (1997), and qualitative measures, being the logbooks completed by participants and three semi-structured interviews conducted, to address these questions. The current study uses both the functional approach to deliberate self-harm, that classifies self-harm according to the four functions that produce and maintain such behaviour, and the environmental model that emphasises the situational influences on the contagion of deliberate self-harm. The findings of the study indicate that 10 of the 12 adolescent participants have experienced either the acquisition or episodes of co-occurrence of self-harm through contagion, both outside the children's homes and within the children's homes. The contagion of self-harm is influenced by the desensitisation and growing prevalence of self-harm, frequent observations of self-harm, close personal relationships between individuals who selfharm, and the influence of the visual media. With regard to the findings of the DSHI, the methods most commonly employed for self-harm in the study include cutting, carving words into the skin, as well as the breaking of bones; the majority of the methods had been employed by the participants within the last year; and the emotions present immediately prior to the episode of self-harm include anger, depression, sadness, frustration, anxiety and disappointment. Findings from the FASM indicate that the motivation for the majority of the adolescent participants' self-harm is 'to stop bad feelings'. Furthermore, the findings of the study indicate that psychological intervention may be available to adolescents in several situations; that the personal histories of the adolescent participants include experiences of physical, emotional and sexual abuse, parental unavailability, the observation of parental alcoholism, as well as the experience of human trafficking; and suicide attempts have been made by the participants following instances of perceived ineffectiveness of self-harm. From the findings, it is evident that the contagion of self-harm is no longer a hypothetical phenomenon. Further implications of the study include the need for continued research on the methods reported by South African individuals who engage in self-harm that are not as prevalent in other research; and the influence of the study on the development and implementation of interventions to address self-harm in children's homes. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

Sijaric, M. ”Ni ska fan få se hur djupt jag kan skära mig”. Upplevelsen av att bli bemött av vårdpersonal när en har ett självskadebeteende. Examensarbete i socialpsykiatri 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, institutionen för socialt arbete, 2019. Studien är av utvärderande karaktär där syftet är att undersöka individers uppevelser av möte med vårdpersonal, med Nationella Självskadeprojektets (NSP) rekommendationer för insatser vid självskadebeteende som utångspunkt. I bakgrunden skrivs förklaringar på olika begrepp gällande självskadebeteende, tidigare forsknings lyfts samt sammanfattningar på NSPs rekommendationer. Metoden som användes för att samla data var kvalitativa intervjuer och analysen som användes var tematisk analys med deduktiv ansats. Resultatet visade att vårdpersonal som går i linje med NSPs rekommendationer fick individer att uppleva en god och adekvat vård. Slutsatsen visade att denna studie motsäger större delen av tidigare forskning där den tidigare forskningen inom ämnet visat att upplevelsen varit ofördelaktig för individer som sökt vård för självskadebeteende. Nyckelord: bemötande, psykiatri, psykisk ohälsa, självskadebeteende / “You’ll see how damn deep I can cut myself”. The experience of treatment by health care professionals when one has self-harmed. Degree project in social psychiatry 15 högskolepoäng. Malmö University: Faculty of Health and Society, Department of Social Work, 2019. The study is of evaluative characteristics where the aim is to examine the individual experience of treatment and meetings with health professionals, using National Self-harm projects recommendations for interventions in self-harm behavior as a foundation. In the background, explanations are written on various concepts regarding self-harm, previous research and studies, and summaries on NSP’s recommendations. The method used to collect data was qualitative interviews and the analysis used was thematic analysis with a deductive approach. The result showed that health care professionals who are in line with NSP’s recommendations led individuals to experience good and adequate care. The conclusion showed that this study contradicts most of previous research, in which subjects showed that the experience was unfavorable for individuals who sought care for self-harm. Keywords: health care professionals, mental illness, psychiatry, self-harm, treatment