Bakgrund: Unga kvinnor som skadar sig med sin sexualitet har uppmärksammats på senare år. De som tidigare i livet varit utsatta sexuellt är överrepresenterade bland dessa kvinnor som skadar sig själva med sexualitet.Syfte: Syftet med studien var att beskriva unga kvinnors upplevelser av sexualitet som självskadebeteende.Metod: En kvalitativ studie med fenomenologisk ansats av egna skrivna berättelser. Datamaterialet analyserades med hjälp av innebördsanalys.Resultat: Unga kvinnor som skadar sig genom sexualitet söker bekräftelse bland annat genom att publicera bilder på internet för att få positiv feedback om det egna utseendet. Vidare använder de sin sexualitet till att uppnå en kick och få en känsla av att duga till och på sätt dämpa den ångest de bär på. Dessa unga kvinnor behöver mycket stöd från omgivningen för att kunna förstå och bearbeta sitt självskadebeteende.Slutsats: Skolsköterskor behöver uppmärksamma att sexualitet som självskadebeteende existerar och finns i alla samhällsklasser. Skolsköterskor kan genom kontinuitet och förtroendegivande bemötande skapa en god relation som bygger på ett genuint intresse att vilja förstå dessa unga kvinnor utifrån ett livsvärldsperspektiv. För att kunna erbjuda det stöd som dessa unga kvinnor behöver är det viktigt att hen vågar finnas där, lyssna och ställa frågan. / Background: Young girls that self-harm themselves have recent years been in focus. Thosewho earlier in life have been sexually abused are overrepresented among these women thatself-harm themselves through their sexuality.Aim: The aim of this study was to illustrate young women’s experiences of sexuality as aself-harm behavior.Method: A qualitative study with a phenomenological approach of own written stories.Result: Young women that harm themselves with their sexuality seek acknowledgement forinstance by publishing pictures on the internet to receive positive feedback on theirappearance. Further they use their sexuality to achieve a rush and a sense of suffice and bythat mitigate their anxiety. These women need a lot of support from their surroundings inorder to understand and process their self-harm behavior.Conclusion: School nurses need to pay attention that sexuality as a self-harm behavior existsin all social classes. The school nurse can through continuity and a trustworthy attitude createa good relation that is based on a genuine interest of wanting to understand these youngwomen from a life-world perspective. To be able to offer these young women the supportthey are in need of it is important that the school nurse dare to be present, listen and ask the question.

No description available.

Bakgrund: Självskadebeteende är skador mot den egna kroppen genom att skära, rispa eller bränna sig utan avsikt att ta sitt liv. Det framkommer att personal känner bristande förståelse och frustration för patienter med självskadeproblem och att de inte vet hur man ska ta hand om dem. Syfte: Att beskriva hur sjuksköterskor inom psykiatrisk heldygnsvård upplever att vårda patienter med självskadebeteende. Metod: En kvalitativ metod användes och datainsamling skedde via intervjuer med sjuksköterskor inom den psykiatriska heldygnsvården (n=14). Materialet transkriberades och analyserades med innehållsanalys. Resultat: Analysen resulterade i ett tema, tre kategorier och sex underkategorier. Temat blev ”Vad göra”, de tre kategorierna blev ”En patientgrupp i nöd”, ”En patientgrupp som berör” och ”En behövande profession”. De sex underkategorierna blev ”Dåtidens brister”, ”I stridens hetta”, ”Mig som sjuksköterska”, ”Oss i personalgruppen”, ”I behov av stöd och vägledning” och ”I kunskapstörst”. Konklusion: Patienter med självskadebeteende berör den enskilda sjuksköterskan men också personalgruppen. Upplevelser vittnar om en patientgrupp i nödliknande situation både förr och idag. Förhoppningen är att med stöd, ökad kunskap och vägledning till verksamma sjuksköterskor förändra upplevelserna av att vårda patienter med självskadebeteende / Background: Self-harm is damage to the own body and includes cut, scratch or burn without intending to take one´s own life. It appears that staff feel lack of understanding and frustration for patients who self- harms and that they don´t know how to care for them. Aim: To describe nurses experiences of caring for patients who self- harm in psychiatric inpatient care. Methods: A qualitative approach was used and data collection was done through interviews with nurses in psychiatric inpatient care (n = 14). The interviews were transcribed and analyzed by content analysis. Results: The analysis resulted in one theme, three categories and six subcategories. The theme was "What to do", the three categories were "A population in need", "A population who affect" and "A profession in need". The six subcategories were "The inadequacies of yesterday”, "In the heat of battle," "Me as a nurse," "us in the personnel”, " "In need of support and guidance," and "In thirst for knowledge". Conclusion: Patients who self- harm affects the individual nurse but also the staff group. Experiences indicate a patient population with a situation in needs, both past and present. It is hoped that with the support, increased knowledge and guidance to the active nurses changing experiences of caring for patients with self-injurious behavior.

Prison self-injury rate accelerates at four times the rise in population” (The Howard League for Penal Reform; 2008a) The rise in self-harm figures in forensic settings in 2003 may largely be due to the improvement in the reporting of self-harm levels in prisons in December 2002. However it does not account for the continued rise in self-harm figures during the years that followed. Despite the increase, there have been few interventions to support prisoners who self-harm, particularly in remand settings. For this purpose the Carousel programme was designed by a counselling psychologist specifically to meet the demands of the female remand population. The aim of this study was to evaluate the effectiveness of Carousel. Forty women who had a history of deliberate self-harm entered and completed the programme through means of self-referral. The study employed both a quantitative and qualitative methodology to evaluate the programme. Participants were interviewed and assessed both at the start and completion of Carousel. This included monitoring levels of self-harm incidents, levels of anxiety and depression using the 14-item Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983), and coping levels using the 60-item Coping Styles Questionnaire (CSQ) (Roger, Jarvis & Najarian, 1993). Results showed a significant decrease in depression and anxiety, a reduction in self-harm levels and a change of coping styles in the desired direction. Qualitative methodology using content analysis was employed to ascertain the components of the programme which were deemed most helpful or unhelpful to the participants. Findings suggest that the most useful components within the programme are coping strategies, management of self-harm behaviours, antecedent, behaviour and consequence (ABC) sessions and the understanding of the brain and associated emotions with self-harm behaviours. Implications for counselling psychology and clinical practice are highlighted and limitations of the current study and directions for future research suggested within the report.

The aim of this study was to investigate how adults 25 years old and over describe the functions of their non-suicidal self-injury (NSSI) and to explore whether they report any changes in their experience with NSSI as they become older. Qualitative e-mail interviews were used in order to capture the participants’ experiences. The results of the study were analysed based on coping theory and previous research. The results indicate that, consistent with previous literature, adults self-injure for mostly the same reasons as adolescents – however, as the previous research shows adolescents are more likely to hurt themselves in order to communicate with others. The adults in the present sample report using problem-solving coping strategies to the same extent as emotion-focused strategies; a slight deviation from previous research which has suggested that people who self-injure are more likely to employ emotion-focused strategies. The participants of the study generally experience a feeling of increased control and deliberation of their self-injury as they have gotten older; hurting themselves has become a purposeful coping strategy. The results of this study might have implications for treatment of self-injury in adults; focusing the treatment on strengthening the adults’ autonomy and encouraging further problem-solving coping strategies might be beneficial.

Patients who self-harm reported negative staff attitudes towards them on presentation to an Emergency Department (ED). The present research aims to explore staff attitudes and behaviours (own and perception of others’) and the impact of this on behaviour, barriers and facilitators of effective treatment, and team identification and norms. Ten staff members from one ED were interviewed, representing all major professional groups working non-therapeutically in the ED. A thematic framework analysis was applied and cross-referenced with another researcher and participants for validation. Analysis identified the following themes: Beliefs about self-harm, attitudes and behaviours, influences on behaviour, and identity, culture and role; related through an overarching theme of balancing difference and diversity. Evidence of PI was found, although interviewees were able to accurately recognise a mixture of beliefs and attitudes in both themselves and others. Influences on behaviour and identity were important in gaining a contextual perspective, and the concept of a ‘fluid team’, relating to patient needs, was highlighted. Results suggest that exposure of the phenomenon of PI may be useful, in conjunction with training to minimise feelings of failure/frustration. This could increase understanding and improve patient care; however, further research is required prior to this. Team stability must, however, be considered. Limitations included restricted participation across one ED and a powerful advocate for mental health patients. Although this is positive for the department, it may set it apart from others.

A link between binge drinking, negative sexual health outcomes, and sexual victimization among university populations is well established in the research literature (Messman-Moore et al., 2013; PHAC, 2016; Smith et al., 2009). Despite these known risks, young people often hold beliefs that alcohol consumption can enhance or facilitate their sexual experiences, however, less is known about the role of alcohol in young women’s consensual sexual experiences. In this qualitative study, I used a feminist perspective to explore young women’s perceptions and experiences of the role of alcohol in their sexual agency – the ability to communicate and fulfill their sexual desires and boundaries – and the social norms that influence this relationship. I collected data through interviews with 14 young university women between the ages of 19 and 25 who identified as heterosexual, lesbian, bisexual, or queer. Participants identified heteronormative sexuality norms that influence the role of alcohol in their sexual agency, namely the prioritization of women’s sexual inexperience, female sexual fidelity, and women’s attractiveness. Participants perceived that alcohol influenced their sexual agency at an individual and social level. In their individual experiences, participants discussed the dis-inhibitory effects of alcohol as a “tool” to alleviate feelings of shame associated with sexual expression and negative body image. At a social level, participants used alcohol as a means to deflect social stigma associated sexual expression as they could “blame the alcohol” as their motivation for engaging in sexual activity. These findings suggest that young women’s motivations for drinking may be linked to sexuality norms that discourage young women’s sexual agency, which could be relevant to consider in health promotion and harm reduction efforts. / Graduate / 0573 / 0453 / 0733 / 0758 / eecusack@gmail.com

Bakgrund: Självskadebeteende är ett sedan länge förekommande fenomen som kan vara framträdande hos patienter med en oförmåga att reglera affekter. Det innebär ett lidande för patienterna och det bidrar till en känslomässig påverkan hos sjuksköterskorna. För att skapa en gynnsam omvårdnadsrelation behövs resurser, kunskap, kompetens och stöd för sjuksköterskorna i omvårdnaden. Syfte: Beskriva sjuksköterskans erfarenheter och upplevelser av att vårda patienter med självskadebeteende. Metod: Data samlades in från sex sjuksköterskor genom kvalitativa semi-strukturerade intervjuer med stöd av en intervjuguide. Materialet har analyserats med kvalitativ innehållsanalys. Resultat: Det framkom fyra kategorier "Att självskada", "Behov av kompetens", "Ge omvårdnad" och "Känslomässig påverkan". Sjuksköterskorna lyfte svårigheter i omvårdnaden, behovet av kompetens och den känslomässiga påverkan de drabbades av i mötet med patienter med självskadebeteende. Slutsats: Självskadebeteende skapar många olika känslor hos sjuksköterskorna, både positiva och negativa. Sjuksköterskorna upplevde att patienter med självskadebeteende var en svår, men intressant grupp att arbeta med. Tidsbrist, stress och upprepade självskadehandlingar var påfrestande och de känslor som uppkom hos sjuksköterskorna var inte alltid lätta för dem att hantera. Sjuksköterskorna poängterade vikten av att fånga upp patienter i tid men beskrev även svårigheterna i att kunna göra det. Sjuksköterskorna efterfrågade utökat stöd, kunskap och bättre resurser för att känna sig trygga i sin yrkesroll samt för att kunna erbjuda patienter med självskadebeteende en god och säker omvårdnad. / Background: Self-harm behavior is a long-standing phenomenon and is often prominent in the inability to regulate emotions. It creates suffering for the patients and it provides an emotional impact of the nurses. In order to create a favorable caring relationship resources needed, expertise and support for nurses in nursing. Purpose: Describe nurses' experiences of caring for patients with self-harm behavior. Method: Data were collected from six nurses through qualitative semi-structured interviews with the support of an interview guide. The material was analyzed using qualitative content analysis. Results: It emerged four categories "to self-harm," "Need for skills", "Giving care" and "emotional impact". The nurses lifted the difficulties in the care, the need for skills and the emotional impact they suffered in the meeting with patients with self-harm behavior. Conclusion: Patients with self-harm behavior have an emotional impact on nurses, giving them both negative and positive feelings. The nurses felt that patients with self-harm behavior were a difficult, but interesting group to work with. Lack of time, stress and repetitive self-harm behavior were stressful for the nurses. The nurses requested more support, knowledge, competence and resources to feel safe and strong in their professional capacity and to able to offer a high-quality care for the patients.

Självskadebeteenden bland ungdomar är ett allvarligtsamhällsproblem som tycks öka. Ett flertal faktorer såsom utsatthet iskolan och vilken eller vilka sociala grupperingar en ungdom uppleversig tillhöra har i tidigare studier identifierats som riskfaktorer för attutveckla självskadebeteenden. Syftet med studien var att undersökaom utsatthet och alternativa sociala grupperingar utgör riskfaktorer försjälvskadebeteenden, samt om det finns en interaktionseffekt mellandessa faktorer i att predicera självskadebeteenden. Studien baseradespå longitudinell data insamlad bland högstadieungdomar på sju skolori centrala Sverige. En multipel regressionsanalys utfördes för att testainteraktionstermen mellan variablerna över tid. Resultatet bekräftadebåde utsatthet i skolan och identifiering med alternativa socialagrupperingar som riskfaktorer, samt att det fanns en interaktionseffektmellan de båda som ytterligare ökar risken för utvecklandet avsjälvskadebeteenden hos ungdomar. / Self-harm is a major public health concern amongst adolescents thatappears to be increasing. Several risk factors have in previous researchbeen associated with self-harm, such as peer harassment and the peercrowd or crowds an adolescent identifies with. The aim of this studywas to examine whether peer harassment and identification withalternative peer crowds constitutes risk factors and whether there wasan interaction effect between these factors in predicting self-harm. In alongitudinal study, students from seven secondary schools in centralSweden responded to a questionnaire. A multiple regression analysiswas conducted to test the interaction between these variables overtime. The results confirmed that both peer harassment andidentification with alternative peer crowds were risk factors for selfharmingbehaviors, as well as there was an interaction effect, namelythat the adolescents who were exposed to peer harassment andidentified with particular social crowds were particularly at risk fordeveloping self-harm behaviors.

Introduction: The World Health Organization (WHO) has declared hookah smoking to be a significant public health problem. According to Martinasek et al. the increase in the number of hookah smokers is due to lack of education and public awareness, there is a general impression that hookah is a safe alternative to cigarettes. (Martinasek et al., 2011). On the other hand, hookah is affordable and has appealing flavor. The US Food and Drug Administration does not regulate hookah and there is a lack of regulation in packet labeling (Martinasek et al., 2011). Hookah smoking and cigarette smoking produces the exact same toxic chemicals and carcinogens (Martinasek et al., 2011). The US Environmental Protection Agency claims that hookah smoking releases secondhand smoke which contains cancer causing agents (Martinasek et al., 2011). Overall, hookah smoking is increasing rapidly among youth due to social acceptance, low cost, appealing flavors, lack of regulatory policies and incorrect harm perception. Therefore, I propose a study that will aim to answer the following research questions: 1) What are the socio-demographic characteristics of middle school and high school students who have awareness of hookah? 2) What are the characteristics of middle school and high school students who report hookah is less harmful than cigarettes? 3) Does awareness of hookah, harm perception of hookah, ever user and current user of hookah differ by living with hookah users? 4) How does harm perception of hookah correlate with use of hookah among US youth? I hypothesize that American youth who perceive hookah as less harmful than cigarettes will more likely be users of hookah as compared to youth who perceive these products are more harmful. Methods: The secondary data analysis was conducted using the data from the 2013 National Youth Tobacco Survey (NYTS). The study population was middle and high school students. The independent variables of interest were students who were current users of hookah, had ever used hookah, as well as those aware of hookah smoking. The dependent variable was harm perception of hookah smoking. A weighting factor was adjusted in the survey to get a weighted proportion of students in each grade to match with the national population. The prevalence of current and ever users of hookah, as well as those aware of hookah among middle school and high school students, was examined. The frequency of high school and middle school students who are living with hookah users, and those who were not evaluated. The association of harm perception of hookah among current and ever users, as well as those aware of hookah smoking adjusted by those who are living with hookah users was assessed. Data was analyzed in SAS 9.3 to examine the association between the independent and dependent variables. Frequency, logistic regression and a chi-square tests were used to find the odds ratio and p-value between the dependent and independent variables. Results: Association of harm perception of hookah among current users of hookah, ever users, as well as those aware of hookah smoking, reported that 55.64% of current users of hookah (Adjusted OR = 4.99, CI: 3.78-6.59), 43.80% of ever users of hookah (Adjusted OR = 4.96, CI: 4.02-6.13) and 21.50% of those who were aware of hookah smoking (Adjusted OR = 3.20, CI: 2.82-3.91) believed that hookah smoking is less harmful than cigarette smoking in both middle and high school. Participants who were current users of cigar smoking i.e.26.57% (crude OR = 2.80 CI: 2.45-3.20), Adjusted OR = 1.18, CI: 0.96-1.45)) as well as ever users of cigar smoking i.e. 24.76% (crude OR= 3.18, CI: 2.78-3.65), adjusted OR = 2.24, CI: 1.85-2.71)) believe hookah smoking is less harmful than cigarette smoking compared to individuals who were not current as well as ever users of cigar smoking. There was no significant difference between odds of male and female in believing that hookah smoking is less harmful than cigarette smoking. Discussion: Overall these results suggest that students who were associated with hookah usage believe that hookah smoking is less harmful than cigarette smoking. Moreover, students who were ever users of cigar smoking had 2.24 odds of believing that hookah smoking is less harmful than cigarette smoking compared to individuals who were not ever users of cigar smoking. Conclusion: Therefore, American youth who perceive hookah as less harmful than cigarettes will more likely be users of hookah as compared to youth who perceive these products are more harmful