References
Changing paramedic students' perception of people who self-harm
Abstract
Aim:
This study aimed to identify whether paramedic students' perceptions of patients who self-harm changed following an educational intervention.
Background:
Self-harm is a major public health concern with an increasing number of incidents being reported in England. Paramedics are often the first contact for those who self-harm and antipathy to these patients among caregivers, including paramedics, has been reported. Negative attitudes to patients who self-harm from health professionals is a considerable barrier to their care. Education on self-harm for paramedics has been historically inadequate, even though it can potentially improve attitudes and how these practitioners engage with those who self-harm.
Method:
A pre- and post-survey analysis was undertaken to examine whether any identified unsympathetic perceptions of paramedic students (n=30) towards patients who self-harm would decrease following an educational intervention, using a validated questionnaire measuring attitudes to self-harm.
Results:
Perceptions of people who self-harm were generally moderately negative prior to the educational intervention, with a significant drop in negative attitudes after it was completed. A survey showed that this drop was also mostly sustained 10 months later.
Conclusion:
Educational interventions may help to reduce negative perceptions of patients who self-harm in paramedic students.
This article reports on a quantitative study which investigated the impact of an educational intervention for paramedic students attending a university in the Thames Valley region in the south east of England on their perceptions of people who self-harm. It also looked at the implications of the intervention for the preregistration paramedic curricular programme.
Several terms are used to describe self-harm, such as self-injury, self-mutilation, self-injurious behaviour, self-wounding and deliberate self-harm. There is no universal definition, resulting in diverse interpretations about the purpose of this self-inflicting injurious behaviour (Ramluggun, 2013; Shaw and Sandy, 2016). Self-harm refers to intentional self-poisoning or self-injury, irrespective of type of motive or the extent of suicidal intent (National Institute for Health and Care Excellence (NICE), 2011).
There are a plethora of social and psychological triggers for self-harm. While there are multiple reasons, these are predominantly related to the regulation of emotion from distressing thoughts and feelings (RCP, 2020). Common types of self-harm include cutting, burning, scratching, self-hitting, inserting objects in the skin or swallowing objects and drug overdose (Royal College of Psychiatrists, 2020), with cutting being the most common type used by adolescents (Gillies et al, 2018). A dissociative state, which is an altered state of consciousness where there is a disconnect in mental processes such as thoughts and feelings, has been reported to precede some acts of self-harm (Colle et al, 2020). Hence, self-harm is also used in an effort to end dissociative experiences such as emotional numbness and to stimulate emotional and physical sensations that make people feel real and alive again (Klonsky, 2007).
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