title: Struggling for hopefulness: a qualitative study of Swedish women who self-harm.
abstract: There has been an increase in the number of Swedish psychiatric patients who self-harm, yet self-harm is seldom described in published research. The aim of this study was to describe how people who self-harm experience received care and their desired care. Nine participants, all Swedish women who had been treated for inpatient or outpatient psychiatric care, narrated their experiences of care for self-harm. Using qualitative content analysis, two themes were formulated: 'Expecting to be confirmed while being confirmed fosters hopefulness'; and, 'Expecting to be confirmed while not being confirmed stifles hopefulness'. Each of these themes emerged from five subthemes that clustered around positive and negative aspects of being seen-not being seen, being valued-being stigmatized, being connected-disconnected, being believed-doubted, and being understood-not being understood. Of significance is for nurses to view persons who self-harm as human beings and to grasp the importance of being confirmed by staff that can foster hopefulness in persons who self-harm, yet realize the possibility of the paradoxical nature of hopefulness and being confirmed.
authors.affiliation: Department of Nursing, Umeå University, Umea, Sweden. Britt-marie.lindgren@nurs.umu.se
authors.forename: B-M
authors.initials: BM
authors.lastname: Lindgren
authors.forename: C
authors.initials: C
authors.lastname: Wilstrand
authors.forename: F
authors.initials: F
authors.lastname: Gilje
authors.forename: B
authors.initials: B
authors.lastname: Olofsson
mesh_terms: D000328:Adult; D000739:Anecdotes as Topic; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D020380:Needs Assessment; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011568:Psychiatric Nursing / Q000592:standards*; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000451:nursing* / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D016387:Women's Health