预防和处理自我伤害的适当干预措施：对服务使用者观点的质性探索。
Appropriate interventions for the prevention and management of self-harm: a qualitative exploration of service-users' views.
作者信息
Hume Megan, Platt Stephen
机构信息
Research Unit in Health, Behaviour and Change, School of Clinical Sciences & Community Health, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK.
出版信息
BMC Public Health. 2007 Jan 19;7:9. doi: 10.1186/1471-2458-7-9.
BACKGROUND
The engagement of service-users in exploring appropriate interventions for self-harm has been relatively neglected in comparison with clinical studies focusing on the management and prevention of self-harm. The purpose of this study was to investigate perceptions of interventions for self-harm (formal and informal, prevention and treatment) among people who have first-hand experience as a result of their own behaviour.
METHODS
Semi-structured interviews were undertaken with 14 patients admitted to hospital following a repeat act of self-harm. Data analysis was undertaken thematically, drawing broadly on some of the principles and techniques of grounded theory
RESULTS
The patients were a heterogeneous group with respect to their personal characteristics and the nature of their self-harm. Thirteen of the 14 patient accounts could be assigned to one or more of three overlapping experiential themes: the experience of psychiatric illness, the experience of alcohol dependency, and the experience of traumatic life events and chronic life problems. These themes were related to the nature of patients' self-harm and their experiences of, and attitudes towards, interventions for self-harm and their attitudes towards these. There was a clear preference for specialist community-based interventions, which focus on the provision of immediate aftercare and acknowledge that the management of self-harm may not necessarily involve its prevention. The findings generate the preliminary hypothesis that personal circumstances and life history are major influences on the choice of interventions for self-harm.
CONCLUSION
This study attests to the importance of recognising differences within the self-harming population, and acknowledging patients' personal circumstances and life history. These may provide clues to the antecedents of their self-harm, and lead to more acceptable and appropriate treatments.
背景
与专注于自我伤害管理和预防的临床研究相比，服务使用者参与探索自我伤害的适当干预措施相对受到忽视。本研究的目的是调查有过自身行为导致的第一手经验的人群对自我伤害干预措施（正式和非正式、预防和治疗）的看法。
方法
对14名因重复自我伤害行为入院的患者进行了半结构化访谈。数据分析采用主题分析法，广泛借鉴扎根理论的一些原则和技术。
结果
患者在个人特征和自我伤害性质方面是一个异质群体。14名患者的叙述中有13个可以归为三个重叠的经验主题中的一个或多个：精神疾病经历、酒精依赖经历以及创伤性生活事件和慢性生活问题经历。这些主题与患者自我伤害的性质以及他们对自我伤害干预措施的经历和态度有关。患者明显倾向于以社区为基础的专业干预措施，这些措施侧重于提供即时的后续护理，并承认自我伤害的管理不一定涉及预防。研究结果提出了一个初步假设，即个人情况和生活史是自我伤害干预措施选择的主要影响因素。
结论
本研究证明了认识自我伤害人群内部差异以及承认患者个人情况和生活史的重要性。这些可能为他们自我伤害的前因提供线索，并导致更可接受和适当的治疗方法。
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