Health-care staff attitudes towards self-harm patients

Sheree J Gibb, Annette L Beautrais, Lois J Surgenor
Australian and New Zealand Journal of Psychiatry 2010, 44 (8): 713-20

OBJECTIVE: To examine attitudes towards self-harm patients and need for training about self-harm amongst health-care staff in Christchurch, New Zealand.

METHODS: Health-care staff from a general and a psychiatric hospital completed a questionnaire about their attitudes towards self-harm patients and their need for training about self-harm.

RESULTS: A total of 195 staff members completed the questionnaire (response rate 64.4%). Overall, health-care staff had both positive and negative attitudes towards self-harm patients. Staff believed that their contact was helpful to self-harm patients, that they were patient and understanding, and were optimistic about patients' outcomes. However, staff did not feel confident working with self-harm patients and believed that their training in this area was inadequate. Attitudes were not significantly associated with age, gender, or experience. However, more negative attitudes were significantly associated with higher levels of burnout (through high emotional exhaustion (p <0.0002) and low personal accomplishment (p <0.003)). Staff comments indicated that their greatest difficulties working with self-harm patients included repetitive self-harm, frustrating and difficult patient behaviour, communication difficulties, and time pressure. Staff suggestions for improvement included more training, provision of a handbook or guidelines, and greater flexibility with patient allocations.

CONCLUSIONS: Overall, health-care staff had positive attitudes towards self-harm patients, and a strong desire to help such patients. However, staff did not feel confident working with self-harm patients and had a strong desire for additional training in this area. Additional staff training in working with self-harm patients could have the potential to increase staff confidence and attitudes and enhance patient care.

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