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Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study / Nigel Rees

DOI (Published version): 10.23889/Suthesis.51912

Abstract

Background:Self-harm (SH) accounts for over 5% of the workload of emergency ambulance services and therefore paramedics are often the first health professional in contact with people who SH. This study aimed to explore paramedics’ perceptions of caring for those who self-harm in order to inform educ...

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Published: 2019
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
URI: https://cronfa.swan.ac.uk/Record/cronfa51912
first_indexed 2019-09-16T14:25:04Z
last_indexed 2023-01-11T14:28:48Z
id cronfa51912
recordtype RisThesis
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spelling 2022-09-27T16:30:24.1687910 v2 51912 2019-09-16 Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study 2019-09-16 Background:Self-harm (SH) accounts for over 5% of the workload of emergency ambulance services and therefore paramedics are often the first health professional in contact with people who SH. This study aimed to explore paramedics’ perceptions of caring for those who self-harm in order to inform education policy and practice. Methods: A systematic review of quantitative literature and metasynthesis of the qualitative literature were conducted and informed the study proper, which took place between 2014–2016 in one UK ambulance service covering a population of three million people. Semi structured interviews were conducted, purposively sampling paramedics until saturation was reached. Interviews were recorded, transcribed verbatim, and coded through open, axial and selective levels of coding, identifying the Basic Social Process (BSP) and developing a Grounded Theory. A second researcher (SH) independently reviewed early results, which were also member-checked with participants. Results:Eleven paramedics were interviewed. The following six categories emerged: Context; Judgements and values; Isolation and system failure; Managing risk; Competence at the boundary of mental and physical health needs; Professional, legal and ethical tensions. The BSP decision making in a context of risk was identified. The final Grounded Theory that emerged was one of ‘Wicked Complexity of paramedic care for people who SH, which includes usual factors such as tiredness and frequent callers, heightened factors including lack of support and pathways, and factors specific to SH such assessing mental health and suicide risk. Conclusions: The study reported in this thesis builds on a very small body of literature to have explored paramedic care for people who SH and has found that this care interaction provides uniquely complex challenges. The multiple influences within the categories defined in this study need considering conjointly when making improvements to care. E-Thesis 31 12 2019 2019-12-31 10.23889/Suthesis.51912 A selection of third party content is redacted or is partially redacted from this thesis. COLLEGE NANME COLLEGE CODE Swansea University Doctoral Ph.D 2022-09-27T16:30:24.1687910 2019-09-16T12:52:07.8493695 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Nigel Rees 1 0051912-16092019143033.pdf Rees_Nigel_PhD_Thesis_Final_Redacted.pdf 2019-09-16T14:30:33.7330000 Output 4214024 application/pdf Redacted version - open access true 2019-09-15T00:00:00.0000000 true
title Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
spellingShingle Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
,
title_short Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
title_full Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
title_fullStr Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
title_full_unstemmed Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
title_sort Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study
author ,
author2 Nigel Rees
format E-Thesis
publishDate 2019
institution Swansea University
doi_str_mv 10.23889/Suthesis.51912
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Background:Self-harm (SH) accounts for over 5% of the workload of emergency ambulance services and therefore paramedics are often the first health professional in contact with people who SH. This study aimed to explore paramedics’ perceptions of caring for those who self-harm in order to inform education policy and practice. Methods: A systematic review of quantitative literature and metasynthesis of the qualitative literature were conducted and informed the study proper, which took place between 2014–2016 in one UK ambulance service covering a population of three million people. Semi structured interviews were conducted, purposively sampling paramedics until saturation was reached. Interviews were recorded, transcribed verbatim, and coded through open, axial and selective levels of coding, identifying the Basic Social Process (BSP) and developing a Grounded Theory. A second researcher (SH) independently reviewed early results, which were also member-checked with participants. Results:Eleven paramedics were interviewed. The following six categories emerged: Context; Judgements and values; Isolation and system failure; Managing risk; Competence at the boundary of mental and physical health needs; Professional, legal and ethical tensions. The BSP decision making in a context of risk was identified. The final Grounded Theory that emerged was one of ‘Wicked Complexity of paramedic care for people who SH, which includes usual factors such as tiredness and frequent callers, heightened factors including lack of support and pathways, and factors specific to SH such assessing mental health and suicide risk. Conclusions: The study reported in this thesis builds on a very small body of literature to have explored paramedic care for people who SH and has found that this care interaction provides uniquely complex challenges. The multiple influences within the categories defined in this study need considering conjointly when making improvements to care.
published_date 2019-12-31T07:48:15Z
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score 11.047501

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