A Qualitative Study of Nurses’ Perceptions and Experiences in Caring for Adolescents With Self-Injurious and Suicidal Behaviors

BACKGROUND: Adolescent self-injurious behaviors (SIBs) present a global public health concern. Nurses, as frontline caregivers, play a crucial role in managing these cases, where their perceptions influence care quality. However, qualitative research deeply exploring these perceptions, particularly in the Zanjan, Iran context, remains scarce. AIMS: To explore the perceptions and experiences of Zanjan nurses caring for adolescents with SIB. METHODS: A qualitative content analysis study. Twelve nurses from general and psychiatric hospitals in Zanjan were purposively sampled. Data from in-depth, semi-structured interviews in Farsi were analyzed using the Graneheim and Lundman approach with MAXQDA software. RESULTS: Analysis of the data generated 449 initial codes, from which three main categories emerged: (1) Conceptualizing Self-Harm: A Spectrum from Distress to Crisis, encompassing subthemes of persistent mental rumination, perceived precipitating factors, and profound emotional impact; (2) Systemic and Clinical Challenges in Care Delivery, comprising subthemes of organizational barriers, care complexities, and limitations in available treatments; and (3) Emotional and Cognitive Responses to the Adolescent, including subthemes of attributions about the person, perceptions of psychological suffering, and recognition of familial struggles. CONCLUSION: Nurses' perceptions ranged from empathy to frustration. Notably, they often conceptualized non-suicidal self-injury and suicidal behaviors as interconnected expressions of distress rather than distinct phenomena. The findings highlight an urgent need for specialized nurse education, institutional support, and interdisciplinary collaboration to improve care. While insightful, the study's focus on one Zanjan province and a small sample size suggests cautious interpretation and indicates a need for broader research.