Knowledge and Attitude Towards the Care For Self-harming Adolescents and the Related Factors in Emergency Department Nurses From Northern Iran

Introduction: Self-harm is a serious health concern, and is relatively common among adolescents. The quality-of-service delivery to self-harming patients is related to the knowledge and attitude of nurses. Objective: This study aimed to determine the knowledge and attitude of emergency department (ED) nurses from northern Iran regarding the care of self-harming adolescents and find the related factors. Materials and Methods: This analytical cross-sectional study was conducted on 208 ED nurses with over 6 months of work experience in the ED of hospitals in Rasht, Iran. They were selected using a census sampling method. The data collection tool was a three-part questionnaire including a sociodemographic form, the attitudes towards deliberate self-harm questionnaire (ADSHQ), and Letho et al.’s knowledge scale. The collected data were analyzed using the Kolmogorov-Smirnov test, Shapiro-Wilks test, Mann-Whitney U test, multiple linear regression analysis, and the Spearman correlation test. Results: The mean age of the nurses was 34.8±7.8 years, and the majority of them were female (90.9%) with a bachelor’s degree (88.5%). The mean total score of knowledge was 0.67±0.12. Nurses’ attitudes were mostly positive, and the total ADSHQ score was 3.59±0.28. The ADSHQ score was significantly different based on nurses’ age (P=0.03) and experience in caring for self-harming adolescents (P=0.033). The ADSHQ score had a positive correlation with the knowledge score (r=0.252, P=0.001). The knowledge score was significantly different based on marital status (P=0.042) and experience in caring for self-harming adolescents (P=0.016). The significant factors for the ADSHQ score in the multiple regression model were the risk factors domain of the knowledge (β=0.334, 95%CI; 1.527%, 3.367%, P=0.001), age (β=0.184, 95% CI; 0.061%, 0.323%, P=0.004) and experience in caring for self-harming adolescents (β=2.4, 95% CI; 0.340%, 4.595%, P=0.023). Conclusion: Nurses’ knowledge in caring of the intentional self-harm adolescents was moderate and their attitude towards these adolescents was positive. In the EDs, it is recommended that nurses with experience dealing with self-harming adolescents be employed. Also, retraining programs should be provided to ED nurses to improve their knowledge and positive attitudes towards caring for self-harming adolescents, focusing on increasing empathy and perceived confidence.