Desire to survive emotional pain related to self-harm: A Norwegian hermeneutic study

The aim of this study was to explore and interpret women's desire to survive emotional pain related to self-harm. Women who suffer from borderline personality disorder describe emotional pain as intense. Previous research indicates that self-harm is a way of obtaining emotional relief and offers an escape from unwanted emotions, thoughts, and/or distressing situations. An explorative, interpretative design was employed. The data were collected by means of in-depth interviews with a sample of women resident in Norway suffering from borderline personality disorder and were analyzed using a hermeneutic approach. The findings revealed one main theme, self-sacrifice, and two other themes, self-harm (a struggle to be relieved of responsibility) and a fear of intimacy versus intrusion. This study indicates that self-sacrifice appears to imply a longing for reconnection with the self and others. To preserve their self-image, the women require courage to survive the painful state of unworthiness.     

Balancing between mental vulnerability and strength in daily life when suffering from eating difficulties*

The aim of this study was to explore the daily life experiences of women who suffer from eating difficulties (ED). The research question was: what mental challenges related to daily life are experienced by women who suffer from ED? ED challenge the daily lives of individuals and their families. The problem is often concealed, and the individuals concerned frequently experience guilt and shame. An explorative design was used. Five women participated in a group programme focusing on experiences of ED, guilt and shame, being a mother and self‐expression. Data were collected using focus group interviews and analysed by means of qualitative content analysis. The main theme Balancing between mental vulnerability and strength comprised three themes: (1) Struggling with emotional ambivalence; (2) Being cognitively aware of limitations; and (3) Experiencing an existential sense of being lost and frozen. The mental challenges were strong and affected the participants' lives. One clinical implication for psychiatric nurses is to acknowledge the strength of emotional, cognitive and existential challenges and make it possible for patients to articulate their exhaustion in spite of their outward appearance of strength.     

Varying views of life among people with long-term mental illness

The purpose of this study was to explore views of life among people with long-term mental illnesses. The participants' possible cognitive inability to express such views dictated a research design that was both fit for purpose and respectful of their integrity. The study, based on an ethnographic framework, involved photographs and interviews with five women and three men. The participants were the photographers, as well as the authors of their own narratives, and the photographs served as a starting point for the interviews. The interview material was analysed in terms of the phases of interpretation. Four main themes were identified: 'thoughts about God and the meaning of life and death', 'the meaning of relationships with others', 'how animals give meaning to life without demands' and 'the symbolic bearing of objects on life'. These four themes represent key existential issues among people with long-term mental illnesses, but they lack confidants to share or discuss these matters with.     

Refocusing acute psychiatry, performance management, standards and accountability, a new context for mental health nursing

The term 'performance management' has an aversive 'managerial' aspect, is unappealing to many public sector staff and has an 'image problem'. Perhaps as a consequence, it has failed to make a significant impact on Irish public sector workers, notably mental health nurses. In this paper, performance management is introduced and examined within an Irish healthcare context and with reference to its use in other countries. Some of the challenges faced by Irish mental health nurses and the potential benefits of working within a performance managed workplace are discussed. The paper concludes that performance management is likely to increasingly affect nurses, either as active agents or as passive recipients of a change that is thrust on them. The authors anticipate that the performance management 'image problem' will give way to recognition that this is a fundamental change which has the potential to enable health services to change. This change will bring high standards of transparency, worker involvement in decision making, an explicit value base for health services and individual teams. It provides the potential for clear practice standards and high standards of transparency as well as worker welfare in all aspects, including supporting employment and career progression.     

Nursing scholarship in Japan: Development, facilitators, and barriers

This qualitative study sought a contemporary view of the development, facilitators of, and barriers to nursing scholarship in Japan from the perspectives of the scholars. In-depth interviews were conducted with 13 scholars across Japan, which were digitally recorded, and the data were subjected to content analysis. Five themes emerged: a spirit of collectivism; a lack of nursing control; a lack of English ability; a high workload; and collaboration. The participants considered that culturally based consensus and communication behaviors, as well as the control and dominance by the medical profession, were hampering nursing scholarship. Furthermore, Japanese nurses were not in control of the profession in a period of unprecedented growth in university nursing education and a growing nursing shortage. A lack of English-speaking and English-writing abilities hindered collaboration with scholars internationally and the writing of international publications. Most of the participants felt unable to compare the extent and nature of Japanese scholarship with that of their Asian neighbors. The Japanese scholars need to grasp opportunities to learn English, collaborate with other nurses nationally and internationally, learn assertion and political skills to give them the confidence to take control of nursing education, and be more involved in research collaboration and international publications.