Struggling for hopefulness: a qualitative study of Swedish women who self-harm

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.