Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people's perspectives.
Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people's perspectives.
复制标题
DOI：
10.1136/bmjopen-2020-038855
复制
发表时间：
2020-10-28
期刊：
影响因子：
2.9
通讯作者：
Robinson J
中科院分区：
文献类型：
--
作者：
Bellairs-Walsh I;Perry Y;Krysinska K;Byrne SJ;Boland A;Michail M;Lamblin M;Gibson KL;Lin A;Li TY;Hetrick S;Robinson J
全科医生（GP）在支持有自杀行为/自我伤害的年轻人方面发挥着关键作用。然而，很少有人知道年轻人的意见和经验，全科医生的做法，这样的介绍，他们的决定，披露自杀行为/自我伤害的全科医生。此外，现有的自杀风险和/或自我伤害管理指南没有纳入年轻人的观点。本研究旨在探讨年轻人的看法和经验，有关的识别，评估和照顾自杀行为和自我伤害的初级保健设置与全科医生。在西澳大利亚州的珀斯进行了两个定性焦点小组，共有10名年轻人（法师= 20.67岁;范围：16-24岁）。数据收集使用半结构化的，开放式的采访时间表，并使用专题分析进行分析。从重点小组中确定了五大主题。(1)年轻人希望与全科医生进行合作对话，包括询问自杀行为/自我伤害，了解治疗过程和自主决策;（2）年轻人担心在披露自杀行为/自我伤害时失去隐私;（3）年轻人认为标签和评估是有问题的和简化的-不喜欢“风险”和“风险评估”，（4）年轻人强调了全科医生态度的重要性，真正的联系、注意力和非评判性的举止被视为最重要的;（5）年轻人希望得到实际的支持和资源，跟进，以及全科医生在处理自杀行为/自我伤害介绍时的能力。我们的研究确定了年轻人对初级保健环境中自杀行为/自我伤害的识别，评估和护理的几个问题和建议。总之，这些研究结果可以为全科医生资源的开发提供信息，并支持面向青年的最佳做法取得进展。
General practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people’s opinions and experiences related to GPs’ practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people’s perspectives. This study aimed to explore young people’s views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs. Two qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16–24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis. Five major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist—disliking the terms ‘risk’ and ‘risk assessment’, and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs’ attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations. Our study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.
登录
查看更多内容
影响因子：
3.2
作者：
Creswell, JW;Miller, DL
通讯作者：
Miller, DL
影响因子：
5.2
作者：
Farre, Albert;Wood, Victoria;McDonagh, Janet E.
通讯作者：
McDonagh, Janet E.
影响因子：
1.8
作者：
Dovey-Pearce, Gail;Rapley, Tim;McDonagh, Janet E.
通讯作者：
McDonagh, Janet E.
影响因子：
7
作者：
Cooper, Jayne;Hunter, Cheryl;Kapur, Navneet
通讯作者：
Kapur, Navneet
影响因子：
7.6
作者：
Etter, Dillon J.;McCord, Allison;Aalsma, Matthew C.
通讯作者：
Aalsma, Matthew C.