title: Motives for self-harm: views of nurses in a secure unit.
abstract: BACKGROUND
  Self-harm is a widespread behaviour among people with mental health problems. Although guidance on how to manage self-harm is offered, it is still a behaviour that is misunderstood by many nurses. Such misunderstanding is generally attributed to the perceived motives for self-harm and lack of specialized education to manage the behaviour. As a consequence, the care provided is usually inadequate and inappropriate. Yet, research concerning nurses' reasons of users' self-harming behaviours is limited.
  
  
  OBJECTIVE
  This paper reports on a study that explores nurses' explanations of the motives for self-harm in a secure adolescent unit in England.
  
  
  METHODS
  The study utilized a phenomenological methodology with semi-structured individual interviews (n = 25). The data were analysed thematically using interpretative phenomenological analysis.
  
  
  RESULTS
  The findings indicate that the behaviour of self-harm has multiple motives. Examples of these include affect regulation, coping with distress, averting death, regaining control and attention seeking.
  
  
  CONCLUSIONS
  Self-harm is a complex behaviour commonly experienced in secure environments. Nurses assume that users who self-harm are motivated by a desire to seek attention and manipulate others. Users may find these beliefs humiliating. Such feelings may increase users' risks for further self-harm. Most adolescents who self-harm experience unbearable emotions because of their past sexual abusive encounters. They self-harm to regulate these emotions. These affect regulatory functions may act as reinforcers of self-harming behaviours.
  
  
  CONCLUSIONS
  Improved understanding of self-harm and its motives may result in improved nurse-user relationships and thus safer and more effective care provision.
authors: Health Studies, University of South Africa, Pretoria, South Africa. sandypt@unisa.ac.za
authors: P T
authors: PT
authors: Sandy
mesh_terms: D000293:Adolescent; D032763:Behavior Control; D004644:Emotions; D004739:England; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008960:Models, Psychological; D009042:Motivation; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital; D036301:Qualitative Research; D016728:Self-Injurious Behavior / Q000451:nursing* / Q000517:prevention & control / Q000523:psychology*; D057545:Social Stigma
keywords: Adolescents; Motives; Nurses; Secure Environment; Self-Harm