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全科医生如何帮助年轻人避免未来的自我伤害:一项定性研究。

How GPs can help young people avoid future self-harm: a qualitative study.

机构信息

School of Medicine, Keele University, Keele, UK; Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, UK and Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, VIC, Australia.

School of Medicine, Keele University, Keele, UK.

出版信息

Br J Gen Pract. 2024 Nov 28;74(749):e832-e838. doi: 10.3399/BJGP.2024.0209. Print 2024 Dec.

Abstract

BACKGROUND

Self-harm is a growing problem in young people. GPs are usually the first point of healthcare contact for young people aged 16-25 years, after self-harm. GPs can experience barriers to supporting young people and behaviour change theory can help to understand these, and the influences on, GP behaviour.

AIM

To explore the capabilities, opportunities, and motivations (COM-B model of behaviour) of GPs, and their perceived training needs, to help young people aged 16-25 years avoid future self-harm.

DESIGN AND SETTING

This was a qualitative study of GPs in England.

METHOD

Semi-structured interviews were conducted with NHS GPs who were purposively sampled. Interviews occurred in 2021. Data were analysed using reflexive thematic analysis and mapped onto the COM-B model domains. The study's patient and public involvement group supported data analysis.

RESULTS

Fifteen interviews were completed. Four themes were generated. GPs described mixed capabilities, with many feeling they had the physical and psychological skills to support young people to avoid future self-harm, but some felt doing so was emotionally tiring. GPs identified opportunities to better support young people, such as use of electronic consultation tools, but cited lack of time as a concern. GPs reported motivation to help young people, but this can be influenced by their workload. Unmet training needs around communication, knowledge, and optimising safety were identified.

CONCLUSION

GPs are supported by their practice teams to support young people after self-harm, but a lack of time hinders opportunities to do so. Future effective GP-led interventions may improve GP motivation to support young people after self-harm.

摘要

背景

自残在年轻人中是一个日益严重的问题。全科医生通常是 16-25 岁年轻人自残后的第一医疗联系人。全科医生在支持年轻人时可能会遇到障碍,行为改变理论可以帮助理解这些障碍,以及对全科医生行为的影响。

目的

探索全科医生(COM-B 行为模型)的能力、机会和动机,以及他们认为的培训需求,以帮助 16-25 岁的年轻人避免未来自残。

设计和设置

这是一项在英格兰进行的全科医生定性研究。

方法

采用目的抽样法对 NHS 全科医生进行半结构化访谈。访谈于 2021 年进行。使用反思性主题分析对数据进行分析,并将其映射到 COM-B 模型领域。该研究的患者和公众参与小组支持数据分析。

结果

完成了 15 次访谈。生成了四个主题。全科医生描述了混合能力,许多人认为他们有身体和心理技能来支持年轻人避免未来自残,但有些人认为这样做会让人感到情绪疲惫。全科医生确定了一些机会,可以更好地支持年轻人,例如使用电子咨询工具,但他们表示时间不足是一个问题。全科医生报告了帮助年轻人的动机,但这可能会受到他们工作量的影响。确定了在沟通、知识和优化安全方面未满足的培训需求。

结论

全科医生在他们的实践团队的支持下,为自残后的年轻人提供支持,但缺乏时间阻碍了他们这样做的机会。未来有效的由全科医生主导的干预措施可能会提高全科医生在自残后支持年轻人的动机。

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