Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme

Abstract

BackgroundDiffering perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme.MethodsPaired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively.ResultsOf the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert.ConclusionA specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here.

From Judgment to Understanding

“…This study demonstrates the clinical and educational relevance of the training programme developed by Kool et al (2014). It indicates that self-harm training for nurses is valuable for nursing practice, especially when other team members also attend.…”

“…The training programme aimed to improve the attitudes and competencies of professionals, in particular mental health nurses, in their care for patients who self-harm. The training study showed significantly improved attitudes towards self-harm together with increased self-efficacy in working with self-harm patients (Kool et al 2014). The present study explores in what ways these positive changes in attitudes contribute to subsequent changes in the professional behaviour of mental health nurses from their perspective.…”

“…Education programmes on self-harm have been developed and it is evident that a number of these programmes have a positive effect on nurses' self-reported attitudes towards self-harm (Holdsworth et al 2001, Patterson et al 2007, McAllister et al 2009, Kool et al 2014. Furthermore, there is a general assumption among researchers that the nursing care for patients who self-harm will improve as a result of positive changes in attitude (Patterson et al 2007, McAllister et al 2009).…”

“…The present study examines the perceived behavioural changes of mental health nurses who attained positive changes in their attitudes towards patients who self-harm after a training programme. This study succeeds an investigation that used a pre-and post-test design to determine the effects of a training programme among 360 professionals (Kool et al 2014). The training programme aimed to improve the attitudes and competencies of professionals, in particular mental health nurses, in their care for patients who self-harm.…”

“…-participated in the training programme (Kool et al 2014) 10 -14 months before the start of the present study. This period allowed sufficient time for participants to apply the acquired skills in nursing practice and to reflect on their professional experience regarding this application, yet still ensured that participants remembered their behavioural changes (if any) after participating in the training programme.…”