Therapeutic nursing care for reducing self injurious behavior: scoping

Non-suicidal self-injury (SIB) is a distinct behavior from suicide attempts, characterized by intentional self-harm without the primary intent to end life, though it can have fatal consequences. A new scoping review highlights the need for standardized nursing interventions to address this growing global health concern, particularly among adolescents.

Prevalence and Characteristics of Self-Injurious Behavior

Globally, the lifetime prevalence of SIB is estimated to be over 4% in adults, with an average onset age of 17.25 years. The World Health Organization reports a lifetime prevalence of 18% for a single SIB episode in community samples, ranking it as the fifth most common health risk in adolescence worldwide. Females are 1.57 times more likely to engage in SIB than males, and prevalence varies regionally, with rates as high as 59.6% reported in Indonesia and 28.9% in Chinese schools.

The Role of Therapeutic Nursing Interventions

The review identified four therapeutic nursing care approaches effective in reducing SIB: psychological therapy groups, psychoeducation combined with Mindfulness Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy (DBT), and Dhikr therapy – an Islamic meditative practice. These interventions can be applied in both clinical and non-clinical settings.

Key Findings from Included Studies

The studies included in the review encompassed quasi-experimental and retrospective cohort designs, with a total sample size of 258 participants ranging in age from 8 to 40 years. Research was conducted in Saudi Arabia, Indonesia, and China. Psychological nursing groups aim to minimize negative psychological states and promote healthy growth through building close relationships and fostering emotional support. Combining psychoeducation and MBCT focuses on cognitive and emotional restructuring, enhancing self-awareness and regulation. Dhikr therapy, practiced among Muslims, offers a pathway to relaxation and inner peace. DBT, proven effective for suicidal tendencies and SIB, focuses on emotional regulation and interpersonal skills.

Challenges and Future Directions

Nurses currently face challenges in addressing SIB, including differentiating between attempted and prevented self-harm and a lack of standardized intervention programs. The scoping review underscores the need for evidence-based research to guide therapeutic interventions provided by mental health and psychiatric nurses. Further research, particularly randomized controlled trials, is needed to assess the long-term efficacy and comparative results of different interventions. The review acknowledges limitations related to the cultural context of the included studies and the need for more research addressing SIB in diverse populations.

The findings of this review can serve as a guideline for nurses implementing therapeutic care in various settings and populations, emphasizing the importance of a comprehensive, patient-centered approach to managing SIB.