This study elucidates the feelings and the experiences by working with the complex of problems of self-injurious behaviour, of six professionals. The purpose with this study has been to examine the feelings and the experiences of the professionals, coming up when they meet and treat young girls with self-injurious behaviour. The empirical basis of this study is built on interviews of six female professionals, working in the County of Kalmar. The statements of the informants were analyzed out of Goffman’s Role Theory and the norm perspective on social behaviour. Through the interviews we saw that the professionals act out of the rolls that they are expected to. There are expectations from the colleagues, from the clients and from the community that every professional handles in an individual manner. The way they handle the problematic situations varies between persons and depends on the character of the circumstances. The result shows that the work of the professionals arouses many feelings. It varies what kind of feelings they experiences but they do feel fear, powerlessness, sadness, happiness and most of all frustration. They handle their feelings through tutorial, support from the co-workers and through reflection.

<p>This study elucidates the feelings and the experiences by working with the complex of problems of self-injurious behaviour, of six professionals. The purpose with this study has been to examine the feelings and the experiences of the professionals, coming up when they meet and treat young girls with self-injurious behaviour. The empirical basis of this study is built on interviews of six female professionals, working in the County of Kalmar. The statements of the informants were analyzed out of Goffman’s Role Theory and the norm perspective on social behaviour. Through the interviews we saw that the professionals act out of the rolls that they are expected to. There are expectations from the colleagues, from the clients and from the community that every professional handles in an individual manner. The way they handle the problematic situations varies between persons and depends on the character of the circumstances. The result shows that the work of the professionals arouses many feelings. It varies what kind of feelings they experiences but they do feel fear, powerlessness, sadness, happiness and most of all frustration. They handle their feelings through tutorial, support from the co-workers and through reflection.</p>

<p>Självskadebeteende har uppmärksammats allt mer i samhällsdebatten under senare tid. Sjuksköterskan möter ofta patienter med ett självskadebeteende. Syftet med studien var att beskriva sjuksköterskans attityder till patienter med självskadebeteende. Metoden var en litteraturstudie och datamaterialet bestod av nio vetenskapliga artiklar, publicerade mellan åren 2000-2007. Det analyserade materialet bildade tre teman som visade sjuskköterskors attityder till patienter med ett självskadebeteende: Ej rätt till vård, Erbjuder vård utan hopp om förändrat beteende och Rätt till vård.</p><p>Det framkom att känslor som vrede, rädsla, misslyckande och hopplöshet var kopplade till attityderna till patienter med självskadebeteende. Faktorer som kan påverka sjuksköterskans attityd till självskadebeteende kan inte enkelt beskrivas som negativa eller positiva enligt denna litteraturstudie. Fortsatta studier kan inriktas på att beskriva om attityderna förbättras eller inte och vilka faktorer som påverkar attityderna.</p>

Självskadebeteende har uppmärksammats allt mer i samhällsdebatten under senare tid. Sjuksköterskan möter ofta patienter med ett självskadebeteende. Syftet med studien var att beskriva sjuksköterskans attityder till patienter med självskadebeteende. Metoden var en litteraturstudie och datamaterialet bestod av nio vetenskapliga artiklar, publicerade mellan åren 2000-2007. Det analyserade materialet bildade tre teman som visade sjuskköterskors attityder till patienter med ett självskadebeteende: Ej rätt till vård, Erbjuder vård utan hopp om förändrat beteende och Rätt till vård. Det framkom att känslor som vrede, rädsla, misslyckande och hopplöshet var kopplade till attityderna till patienter med självskadebeteende. Faktorer som kan påverka sjuksköterskans attityd till självskadebeteende kan inte enkelt beskrivas som negativa eller positiva enligt denna litteraturstudie. Fortsatta studier kan inriktas på att beskriva om attityderna förbättras eller inte och vilka faktorer som påverkar attityderna.

Self-harm is a behaviour constructed as ostracised and abhorrent in most social discourses. While there is an abundance of available research about self-harm, a distinctive gap in the literature concerns how an individual begins to self-harm. Research has indicated that having a friend or family member who self-harms is the strongest predictor of future self-harm, yet no published studies have sought to explain this in detail. This thesis explored how self-harming participants construct their first self-harming experience – a behaviour which appears prima facie to be outside of socially accepted conventions, and suggests that this behaviour may become normalised through knowing other self-harmers. It was found that both participants had a self-harming friend prior to the onset of their self-harming behaviour, and that both participants confided in someone who subsequently began to self-harm. Participants positioned these two categories of individuals in different ways. Participants relied on a ‘victim’ discourse to establish their self-harm as meaningful in a way which limited any blame or stigma attributable to them, but which subsequently limited their agency in their narratives. The discourse of attention-seeking heavily influenced participants’ narratives, and was acknowledged as the dominant discourse self-harmers must contend with in presenting their behaviour as meaningful and rational. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Hälso- och sjukvårdspersonalens bemötande och attityd avspeglas i mötet med patienter med självskadebeteende och är avgörande för utfallet av behandlingen. Den allmänna litteraturöversikten belyser patienters upplevelse av vårdpersonals bemötande inom hälso- och sjukvård. Sökningarna utfördes i tre databaser Cinahl, PubMed och PsycINFO, vilket resulterade i tio kvalitativa vetenskapliga artiklar som granskades, analyserades och bearbetades med utgångspunkt från studiens syfte. I resultatet framkom tre kategorier, bli sedd, vårdmiljöns betydelse och vårdkontaktens betydelse, som visade att positiva uppfattningar av vården var känslan av att bli tagen på allvar, främjandet av integritet samt när vårdpersonal lyssnade. När patienter kände sig dömda på förhand samt upplevde bristande intresse från vårdpersonal, vilket ledde till ytterligare skuld och skam innebar negativa uppfattningar. Tidigare negativa erfarenheter under vårdkontakten ledde till att patienter undviker att söka hjälp. Litteraturöversikten visar på att det krävs mer forskning ur ett patientperspektiv för att utveckla ett bättre evidensbaserat arbetssätt för vårdpersonal som idag möter och behandlar patienter med självskadebeteende. / The health professionals’ attitude reflects in the meeting with patients with self-injury disorder and is crucial for the patients’ treatment. Therefore, it is important to highlight the patients’ experience of the meeting, which is the purpose of this literature study. The study is a systematic literature study with searches performed in three databases, Cinahl, PubMed and PsycINFO. The results were ten qualitative original articles, which have been reviewed, analysed and summed up. In the result three categories emerged: to be seen, environment and care contact, which showed that positive perceptions about health care was the feeling of being taken seriously, the promotion of integrity and that the health care professionals listened. Negative results that emerged was when patients felt pre-judged and also when they felt that the caregivers didn’t really care, which led to further guilt and shame. Previous negative experiences lead to patients feeling reluctant of seeking help. The literature overview shows that more research from a patient's perspective is needed to reach an evidence based and improved way of care giving for health professionals that meet and treat patients with self-injury behaviour.

Bakgrund: Självskadebeteende är fortfarande tabubelagt och förknippat med skam, trots att det är mer uppmärksammat nu än innan. Litteraturen beskriver att dessa patienter ofta bemöts med avsky och okunskap då hälso- och sjukvårdspersonal upplever det problematiskt att förhålla sig till dem. För att öka förståelsen för dessa patienter kommer denna litteraturöversikt att fokusera på patienternas egna erfarenheter av hälso- och sjukvården. Syftet: Syftet var att beskriva erfarenheter av hälso- och sjukvården hos patienter med ett självskadebeteende. Metod: Litteraturöversikt med kvalitativ innehållsanalys av 12 artiklar genomfördes. Resultatet: Fem kategorier skapades: Att finnas men inte synas- erfarenheter av den sviktande organisationen, En miljö som hämmar eller främjar- erfarenheter av den fysiska miljöns påverkan, Att hjälpa eller stjälpa- erfarenheter av personalens attityder, Mellan hopp och förtvivlan- erfarenheter av patientens egna känslor i mötet och Jag är unik men ni väljer att inte se- erfarenheter kring patientens önskemål om en individanpassad vård. Diskussion: Fynden diskuteras utifrån negativa och positiva aspekter samt diskuteras patienternas behov. Utifrån den etiska värdegrunden diskuteras hur vi kan förbättra patienternas erfarenheter av hälso- och sjukvården. Författarna diskuterar även fördelarna med individanpassad vård. / Background: Self- injurious behaviour is still taboo and associated with shame, even though it is more talked about now than before. The literature describe that these patients are still met with disgust and ignorance because the care-staff finds it problematic to relate to them. To increase understanding of this patient group, this literature review focuses on describing patient’s experiences of health-care. Aim: The aim was to describe experiences of health-care among patients with self-injurious behaviour. Method: A literature review with qualitative content analysis, based on 12 articles. Results: Five categories were created: To be but not be seen- experiences of the failing organisation; An environment that inhibits or promotes- experiences of the physical environment; To help or hinder- experiences of the staff´s attitudes; Between hope and despair- experiences of the patients own feelings in the encounter; I am unique but you choose not to see- experiences around the patient’s wishes for an individual- centered care. Discussion: The findings are discussed from a negative and positive view-point; also the patient’s individual needs are discussed. With a basis in ethical values, a discussion around how to better the experiences of health-care is held. The authors also discuss advantages of patient- centered care.

Background Violence is a global public health problem and violence among youth is a matter of high priority. Adolescence and young adulthood are important periods for the foundation of future health. Youth victimization may have serious health consequences, making it important to address the occurrence and socio-medical context for possible interventions against violence. Aims To analyze prevalence, risk patterns and gender differences in emotional, physical, sexual, and multiple-violence victimizations and the associations between violence victimization and sexual ill health, sexual risk behaviors and mental health in Swedish youth. Methods A cross sectional study using two samples, a national sample from nine youth health centers in Sweden and a population-based sample from a middle-sized Swedish city. The questionnaire included standardized instruments addressing violence exposure (NorAQ), socio-demographics, mental and sexual ill-health and sexual risk behaviors, alcohol and substance use. Proportions and crude and adjusted odds ratios with a 95% CI were calculated. Results A total of 2,250 young women and 920 men, aged 15-23, answered the questionnaire at the youth health centers. In upper secondary school, 1,658 women and 1,589 men, aged 15-22, answered the questionnaire. High prevalence rates with gendered differences both in rates and in co-occurrence of different types of violence were found. Women were more often exposed to emotional violence and sexual violence than men, while men were more often physically victimized. For both women and men, violence victimization before the age of 15 was strongly associated with all types of violence victimizations during the past year. Strong associations were found between multiple-violence victimization and poor mental health in both genders. Among the sexually experienced students, consistent associations between lifetime multiple-violence victimization and various sexual ill-health and sexual risk behaviors were found in both genders, except for non-contraceptive use. Conclusions High prevalence of violence victimization in youth and strong associations between victimization, especially multiple victimization, and poor mental and sexual health were found. This needs to be recognized and addressed in social and medical settings.

The following thesis outlines a study assessing the levels of perfectionism, self-injurious behaviour, and functions of anorexia nervosa (AN) through use of a cross-sectional online survey, among English speaking participants 15 years or older, self-reporting a current, previous, or suspected diagnosis of AN. Three distinct clusters were found using self-report measures from individuals with a current or suspected diagnosis, with each cluster corresponding to a unique theoretical understanding of AN. The three clusters can be distinguished by high asceticism, appearance, and avoidance of fertility/sexuality functions for AN respectively. Two distinct clusters were found for participants with a previous diagnosis of AN. These clusters can be differentiated by lingering sentiments held for the condition, as the first cluster viewed AN negatively, and the second cluster continued to see some benefits of the condition. Possible implications for understanding etiology, mechanisms, and treatment of AN are discussed. / Canadian Institute of Health Research

Bakgrund: Tidigare studier har visat att självskadebeteende ökar hos unga kvinnor. Självskadebeteende anses vara ett sätt att uppnå tillfällig lättnad vid psykiskt lidande och bakomliggande orsaker anses i huvudsak vara depression och ångest. Forskning har påvisat att vårdmötet är problematiskt. Det finns vårdare som upplever bristande kunskap och förståelse och känner frustration och maktlöshet inför självskadande patienters handlingar. Många unga kvinnor befarar att deras problem ska förvärras av att söka vård samt fruktar att inte bli tagna på allvar. Syfte: Denna uppsats syftar till att beskriva unga kvinnors upplevelse av att leva med ett självskadebeteende. Metod: En kvalitativ innehållsanalys utfördes på tre olika bloggar. Analysen resulterade i fyra olika kategorier. Resultat: Fyra kategorier identifierades; Det ändlösa lidandet, Beroendet av att skära, Kampen och Behovet av hjälp och stöd. Slutsats: Att leva med självskadebeteende upplevdes vara en kamp mellan hopp och förtvivlan. De unga kvinnornas upplevde ett stort behov av hjälp och stöd och ansåg vården vara oförstående och otillräcklig. / Background: Previous studies have shown an increase in self-injurious behaviour among women. Self-injurious behaviour is considered to be a way to quickly relieve deep emotional distress and is related to depression and anxiety disorder. Studies show that the encounter with the health professionals is often problematic. Many professional caregivers experience a lack of knowledge and understanding and often become frustrated and feel powerless when encountering the self-injurying patient. Many young women have a fear of not being taken seriously if they were to contact the health care services and if they do establish contact; they fear it will only make their problems worse. Aim: This study aims to describe the experiences of young women living with self-injurious behaviour. Method: A qualitative content analysis was based on three different blogs found on the Internet. Four main categories were identified. Results: The four categories were; The endless suffering, The addiction of cutting, The struggle and The need of help and support. Conclusion: Living with self-injurious behaviour is a struggle between hopefulness and despair. The young women experience a great need of help and support and find the health care unsympathetic and insufficient.