Mental health nurses' dispositional decision-making for people presenting to the emergency department with deliberate self-harm: an exploratory study.

There is no clear treatment pathway for people presenting to Australian emergency departments with deliberate self-harm. To explore variations in mental health nurses' disposition decisions for patients following risk assessment for deliberate self-harm. A survey was distributed to mental health nurses. This survey comprised demographic items and questions in response to nine vignettes describing episodes of deliberate self-harm. Dispositional decision and reasoning were also sought for each vignette. Poor levels of agreement for disposition were found. There was a lack of consensus regarding dispositional outcomes. This suggests a high level of subjectivity in decision-making which needs to be taken into account within clinical governance.

Phillips G ，Gerdtz MF ，Elsom SJ ，Weiland TJ ，Castle D ... -  《-》

Deliberate self-harm: emergency department nurses' attitudes, triage and care intentions.

McCann TV ，Clark E ，McConnachie S ，Harvey I ... -  《JOURNAL OF CLINICAL NURSING》

An examination of emergency department nurses' attitudes towards deliberate self-harm in an Irish teaching hospital.

The purpose of this study was to examine emergency department (ED) nurses' attitudes towards individuals presenting with deliberate self-harm (DSH), including the relationship between attitudes and factors such as age, academic achievements, length of experience, and self-harm education. The study adopted a quantitative descriptive and correlational design. ED nurses' attitudes, working in a level 1 trauma ED in the Republic of Ireland, were surveyed, using an amended version of McAllister's et al. [McAllister, M., Creedy, D., Moyle, W., Farrugia, C., 2002. Nurses' attitudes towards clients who self-harm. Journal of Advanced Nursing 40(5), 578-586.] Attitude Towards Deliberate Self-Harm Questionnaire (ADSHQ). The survey yielded an 85% (n=68) response rate. The study found that ED nurses held positive attitudes towards individuals presenting with DSH. No correlation was found between total scores and gender, ED experience, or a history of self-harm education, although older nurses and hospital trained nurses had less positive attitudes. Age and length of clinical experience produced a trend in which attitudes increased, reached a peak and then declined. Although ED nurses in this study hold positive attitudes, ongoing continuing education, which was identified as a key theme in the study, remains an important strategy to maintain and further improve attitudes. The need for research into aspects of care such as knowledge, awareness and empathy is recommended, as is the need to evaluate the extent to which the National Strategy for Suicide Prevention 2005-2014 recommendations [Department of Health and Children, Health Service Executive, National Suicide Review Group 2005. Reach Out - Irish National Strategy for Action on Suicide Prevention 2005-2014. <http://www.nosp.ie/reach_out.pdf> (accessed 22.02.08)] have been implemented.

McCarthy L ，Gijbels H 《-》

Measuring emergency department nurses' attitudes towards deliberate self-harm using the Self-Harm Antipathy Scale.

The emergency department is an important gateway for the treatment of self-harm patients. Nurses' attitudes towards patients who self-harm can be negative and often nurses experience frustration, helplessness, ambivalence and antipathy. Patients are often dissatisfied with the care provided, and meeting with positive or negative attitudes greatly influences whether they seek additional help. A quantitative design was utilised to measure emergency department nurses' attitudes towards deliberate self-harm. The 'Self-Harm Antipathy Scale', a validated questionnaire, was administered to a random sample of nurses in four emergency departments in the Republic of Ireland. A total of 87 questionnaires were returned (87% response rate). Results reveal that nurses show slightly negative antipathy overall, indicating positive attitudes towards self-harming patients. Attitudes were significantly different in accordance with a nurse's age. Education and social judgment also contribute to the way nurses view, interact and make moral decisions regarding self-harm patients. Evidence indicates there is need to improve the training, supervision and support of nurses caring for patients who self-harm, and that practical strategies should be implemented to manage the alienation process and inform practice.

Conlon M ，O'Tuathail C 《-》

Study of Queensland emergency department nurses' actions and formal and informal procedures for clients who self-harm.

McAllister M ，Creedy D ，Moyle W ，Farrugia C ... -  《International Journal of Nursing Practice》