1 Cardiff University, Cardiff, United Kingdom.
Qual Health Res. 2018 May;28(6):939-949. doi: 10.1177/1049732318759935. Epub 2018 Mar 26.
Research on clinicians' interpretations of self-harming practices has shown that they can often be negative. To date there has been limited consideration of other professionals' narratives, notably those working in social care. This article presents focus group and interview data generated with foster carers ( n = 15) and residential carers ( n = 15) to explore the symbolic meanings ascribed to self-harm among the children and young people they care for. Three repertoires of interpretation are presented: survival, which conceives self-harm as a mechanism for redefining the identity of "looked-after"; signaling, which understands self-harm as a communicative tool for the expression of emotion; and security, which sees self-harming practices as testing the authenticity and safety of the caring relationship. Through their focus on sociocultural narratives, carers position themselves as experts on self-harm due to their intimacy with young people's social worlds. This construction potentially creates distance from health professionals, which is problematic given the current privileging of interprofessional working.
研究表明,临床医生对自残行为的解释往往是负面的。迄今为止,对其他专业人员的叙述,特别是从事社会关怀工作的人员的叙述,考虑得还很有限。本文介绍了与寄养照顾者(n=15)和住宿照顾者(n=15)进行的焦点小组和访谈数据,以探讨他们所照顾的儿童和青少年中自残行为的象征意义。提出了三种解释方案:生存,将自残视为重新定义“被照顾者”身份的机制;信号,将自残理解为表达情感的交际工具;以及安全,将自残行为视为对关怀关系真实性和安全性的考验。通过关注社会文化叙事,照顾者由于与年轻人的社会世界密切相关,将自己定位为自残方面的专家。这种建构可能会与卫生专业人员产生距离,鉴于当前对跨专业合作的重视,这是有问题的。