Abstract :

Self-harm and related psychological outcomes are significant mental health concerns among nursing students. These outcomes include self-harm behavior, non-suicidal self-injury (NSSI), suicidal ideation or behavior, self-injury ideation, and exposure to self-harm during clinical practice. This systematic review aimed to synthesize multidimensional factors associated with self-harm and related psychological outcomes among nursing students. A systematic literature search was conducted in Scopus, PubMed, ScienceDirect, CINAHL, and Web of Science for English-language articles published between 2019 and 2026. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools appropriate to each study design. Findings were synthesized using a narrative thematic approach. Eight studies met the eligibility criteria. Four domains of associated factors were identified: (1) personal factors, including psychological distress, emotion-regulation difficulties, self-regulatory fatigue, experiential avoidance, emotional intelligence, and resilience; (2) academic factors, including academic demands and performance pressure where reported; (3) clinical factors, including stressful practicum experiences and witnessing patients’ self-harm; and (4) social and institutional factors, including support, clinical supervision, and debriefing. The findings indicate that multiple personal, academic, clinical, and social conditions are relevant to self-harm and related psychological outcomes among nursing students. However, the included studies assessed heterogeneous outcomes, and associations should be interpreted according to each study’s outcome and design. Nursing educational institutions may consider mental health services, emotion-regulation initiatives, supportive clinical supervision, and post-incident debriefing. Further longitudinal and intervention studies are needed to clarify these relationships and evaluate preventive strategies.

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Keywords :

Emotion Regulation, Non-Suicidal Self-Injury, Nursing students, Psychological Distress, Self-Harm, systematic review.

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References :

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