Browsing by Author "Nel, Annemi"

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    An inquiry into the organisation of care for deliberate self-harm patients in a South African hospital
    (Stellenbosch : Stellenbosch University, 2016-03) Nel, Annemi; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology
    ENGLISH ABSTRACT : Deliberate Self-Harm (DSH) is a significant problem in South Africa. Individualsengaging in DSH have an elevated risk for a subsequent presentation of DSH and for completed suicide. DSH patients also place a burden on the health care system and have shorter life expectancies than the general population. Research suggests that hospital Emergency Departments (EDs) are a site of potential intervention for DSH patients. This study sought to investigate how an ED of a SA urban hospital responded to DSH patients. An ethnographic inquiry was employed to examine the policies, practices, attitudes and knowledge that generated the response by health care professionals. Specifically, the organisational structure of the ED was studied, both in relation to the hospital as well as in relation to the broader health care system. Three different data method collection techniques were used; observations, semistructured interviews and document analysis (pertaining hospital policies). Data was collected over a period of eight months (May – December 2014). Semi-structured interviews were conducted with 28 health care professionals. This sample included medical officers, a medical registrar, medical interns, medical students, nurses, a student nurse, psychiatry registrars, psychologists and social workers. Thematic analysis was implemented to group findings into meaningful themes. This study found that health care professionals are doing their best, under difficult circumstances, to respond to the needs of DSH patients. Nonetheless a number of barriers and opportunities to the provision of care were identified. Significant barriers included the lack of resources, a discontinuity of care, the impossibility of a relationship with the DSH patient, as well as negative attitudes and emotional responses of health care professionals, such as stigmatisation, and negative perceptions. Opportunities to the provision of care included health care professionals’ positive attitudes, such as empathy and a willingness to provide quality care to DSH patients. This research has found that an under-resourced system and negative attitudes of health care professionals prevent the ED from being optimally utilised as a space for intervening with the DSH population. The implementation of existing resources in the ED may be re-examined as to use them optimally.