Heyward-Chaplin Jessica, Shepherd Laura, Arya Reza, O'Boyle Ciaran P
School of Medicine, The University of Nottingham, University Park, Nottingham, UK.
Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK.
Scars Burn Heal. 2018 Mar 20;4:2059513118764100. doi: 10.1177/2059513118764100. eCollection 2018 Jan-Dec.
Rates of self-harm injuries are considered to be increasing. The attitudes of healthcare staff towards patients who self-harm may be negative and a small amount of research specifically investigating burns and plastic surgery healthcare professionals has recently been conducted exploring this issue. This study aimed to determine attitudes towards and adherence to national guidance by healthcare professionals in a UK burns and plastic surgery department with respect to patients who self-harm.
An audit questionnaire, completed in a designated Burns Unit and plastic surgery department, within a UK hospital with a major trauma centre.
Data were obtained from 59 healthcare professionals. The majority of responders held positive attitudes towards those who had self-harmed. However, a significant minority held negative attitudes, stating that they found it difficult to be compassionate (10%; n = 6) and believing that patients usually self-harm to get attention (9%; n = 5). One-fifth (n = 12) agreed that, on a departmental level, conservative management (as opposed to surgery) was offered more frequently for self-harm injuries compared with accidental injuries, contrary to national guidance. Awareness of national guidance in relation to self-harm injuries was markedly lacking, in only 12% (n = 7/59) and the frequency of completing relevant training was low (34%, n = 20/59).
Education among healthcare professionals is important, to ensure adherence to best practice. The findings of this study strongly suggest that many healthcare professionals do not know the current best practice. As a result, these highly vulnerable patients may be receiving sub-optimal care, with consequentially poor outcomes.
自残伤害的发生率被认为在上升。医护人员对自残患者的态度可能是负面的,最近已经开展了少量专门针对烧伤和整形外科医护人员的研究来探讨这个问题。本研究旨在确定英国一家烧伤和整形外科科室的医护人员对自残患者的态度以及对国家指南的遵循情况。
在一家设有主要创伤中心的英国医院的指定烧伤科和整形外科完成一份审计调查问卷。
收集了59名医护人员的数据。大多数受访者对自残者持积极态度。然而,有相当少数人持负面态度,称他们发现很难有同情心(10%;n = 6),并认为患者自残通常是为了引起注意(9%;n = 5)。五分之一(n = 12)的人同意,在科室层面,与意外伤害相比,自残伤害接受保守治疗(而非手术)的频率更高,这与国家指南相悖。明显缺乏对与自残伤害相关的国家指南的了解,只有12%(n = 7/59)的人了解,完成相关培训的频率也很低(34%,n = 20/59)。
对医护人员进行教育很重要,以确保遵循最佳实践。本研究结果强烈表明,许多医护人员不了解当前的最佳实践。因此,这些极易受伤害的患者可能得到的是次优护理,结果也相应较差。