Our assumption is that valuable knowledge about caring for
self-harm patients is embedded in MHNs’ experiences. The
aim of this study was therefore to explore and describe MHNs’
experiences of caring for inpatients who self-harm during an
acute phase.
2. Theoretical Background
A person-centered approach is a valuable perspective for
nursing [30]. In a person-centered approach, the patient is
placed at the center of all care; the patient’s experience of
health and ill-health is taken into consideration during care
and treatment and a focus is placed on an active collaboration
between the nurse and patient [31]. The patient needs to
be understood as a person [31]. Different models exist for
implementing person-centered care across multiple health
care settings [32]. Originally introduced into acute mental
health nursing, the Tidal model [31, 33, 34] is now recognized
as a mid-range nursing theory [31]. In the Tidal model
a range of focused assessments generate person-centered
interventions that emphasize a person’s extant resources and
capacity for solution-finding [34]. An open, honest, nonjudgmental,
and supportive therapeutic alliance promotes
personal development, from fragmentation into wholeness
and from despair into hope [31]. Barker and BuchananBarker
[35] prefer to conceptualize recovery as a process of
assisting people to recover their personal identity through
telling their own story in their own voice. The challenge for
nurses is to facilitate healing through carefully understanding
and creating learning out of patients’ experiences.
3. Materials and Methods
3.1. Design. This study has a qualitative exploratory and
descriptive design.
3.2. Study Setting and Participants. The study setting consisted
of five adult acute care units at four psychiatric clinics
in Norway. Norway does not currently have any national
guidelines for the treatment and care of self-harm patients,
and for this reason various clinics were included in this study
to gain a broader-access, representative, and comprehensive
data material of MHNs’ experiences.
Purposive sampling was used. Inclusion criteria were
that participants were employed 100% at an acute inpatient
psychiatric unit for more than three years as a nurse specialized
in mental health nursing (MHN; three-year Bachelor’s
degree plus one-year specialization training) or as a registered
nurse (RN) with extensive work experience in caring for
self-harm patients. Nurse leaders and specialist nurses with
responsibility for development and quality assurance were
excluded.
The top managers at the four psychiatric clinics were
given written information about the project and gave the
permission for the study. Each nurse manager at the five
units recruited participants who met the inclusion criteria,
and information sheets were used to inform participants
about the study. At the beginning of each interview Randi