Department of Psychology, Lund University, Lund, Sweden.
Clinical Psychiatric Research Center, Department of Clinical Sciences, Lund, Psychiatry, Lund University, Region Skåne, Lund, Sweden.
Nurs Open. 2021 Jul;8(4):1660-1667. doi: 10.1002/nop2.795. Epub 2021 Feb 23.
Traditional methods used when managing self-harm in a psychiatric inpatient setting tend to infringe on the autonomy of the individuals receiving treatment and are often experienced as practically and emotionally challenging by care providers. Therefore, we examined care providers' experiences of an alternative method negotiating self-harm abstinence agreements, which can be viewed as a form of positive risk taking.
A qualitative approach using semi-structured interviews with twelve mental health professionals.
Thematic analysis of the interviews.
Five themes emerged; "No-harm agreements versus constant observation and coercion," "No-harm agreements to promote independence and collaboration," "No-harm agreements' effect on ward safety," "Ambiguity surrounding the no-harm agreements" and "Ethical complexities of the no-harm agreements." These indicated perceived positive effects on the therapeutic relationship, the individuals' autonomous functioning and the ward environment, but also practical and ethical difficulties.
在精神科住院患者环境中管理自残时使用的传统方法往往侵犯了接受治疗者的自主权，并且经常被护理人员视为在实践和情感上具有挑战性。因此，我们研究了护理人员对替代方法协商自残戒除协议的体验，这可以被视为一种积极的冒险形式。
使用半结构化访谈对 12 名心理健康专业人员进行定性研究。
对访谈进行主题分析。
出现了五个主题；“无伤害协议与持续观察和强制”、“无伤害协议促进独立性和合作”、“无伤害协议对病房安全的影响”、“无伤害协议的模糊性”和“无伤害协议的伦理复杂性”。这些主题表明，无伤害协议对治疗关系、个人的自主功能和病房环境有积极影响，但也存在实际和伦理上的困难。
