Ocena vpliva znanja zaposlenih v zdravstveni negi na obravnavo mladostnikov s samopoškodovalnim vedenjem

Pintar Babič, Matejka

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Title:	Ocena vpliva znanja zaposlenih v zdravstveni negi na obravnavo mladostnikov s samopoškodovalnim vedenjem
Authors:	ID Pintar Babič, Matejka (Author) ID Bernik, Mojca (Mentor) More about this mentor... ID Žnidaršič, Anja (Comentor) ID Drobnič Radobuljac, Maja (Comentor)
Files:	MAG_Pintar_Babic_Matejka_2016.pdf (2,83 MB) MD5: 462B2A826F6819EE39859FBDF2C6374F
Language:	Slovenian
Work type:	Master's thesis/paper
Organization:	FOV - Faculty of Organizational Sciences in Kranj
Abstract:	Z izrazom nesamomorilno samopoškodovalno vedenje opišemo namerno povzročanje poškodb lastnega telesa na način, ki ni družbeno sprejemljiv in nima samomorilnega namena. Najpogostejše je v obdobju mladostništva. Posameznikom prinaša različne ugodnosti, načeloma pa služi kot način lajšanja notranjih napetosti. Večina mladostnikov, ki se samopoškodujejo, to storijo z namenom, da bi se pomirili, sprostili in ponovno zmogli nadzorovati svojo čustveno stisko. Prve zapise o samopoškodovalnem vedenju najdemo že v Stari zavezi, med tem ko v današnjih časih predstavlja pogost zdravstveni problem, s katerim se zdravstveni delavci vse pogosteje srečujejo na vseh nivojih zdravstvenega varstva. Kljub temu v slovenskem prostoru ni zaslediti sistematičnega spremljanja samopoškodovanja, med tem ko je bilo na podlagi tujih raziskav ugotovljeno, da zaposlenim v zdravstveni negi primanjkuje znanja o etiologiji motnje in njenem obvladovanju, kar lahko vodi v nerazumevanje in slabšo empatijo zaposlenih ter posledično negativno vpliva na celoten proces zdravljenja. Magistrsko delo je sestavljeno iz teoretičnega in empiričnega dela. V teoretičnem delu se seznanimo s psihopatologijo samopoškodovalnega vedenja in vlogo zdravstvene nege pri obravnavi pacientov s samopoškodovalnim vedenjem. Zajema tudi poglavja o kakovosti v zdravstvu, usmeritvah za razvoj kakovosti ter predstavi vlogo zaposlenih ob uvajanju sprememb. Zaradi pomanjkanja podatkov o samopoškodovalnem vedenju v bolnišničnem okolju smo najprej na podlagi internega kazalnika kakovosti ugotavljali pojavnost in način obravnave z vidika zdravstvene nege v Univerzitetni psihiatrični kliniki Ljubljana (UPK Ljubljana). V pomoč in usmerjanje zaposlenih, pacientov in njihovih svojcev smo izdelali zloženko »Samopoškodovanje in izdelava varnostnega načrta« ter na podlagi smernic Ministrstva za zdravje in nacionalnih načel kakovosti v delovni proces uvajali posamezne spremembe. Empirična raziskava je vključevala več faz. Za prvo fazo, imenovano identifikacija znanja, občutkov in odnosa zaposlenih v zdravstveni negi ob obravnavi pacientov s samopoškodovalnim vedenjem, smo opravili tri intervjuje. Na podlagi teh in ob pregledu raziskav, ki so bile izvedene v tujini, je bil izdelan vprašalnik, temu je sledila obširnejša raziskava. Podatke smo zbirali s kvantitativno tehniko, in sicer s samoocenjevalnim vprašalnikom zaprtega tipa. Anketiranje je potekalo v dveh delih, pred in po izobraževanju. Na podlagi izobraževanj smo želeli povečati senzibilnost zaposlenih, da prepoznajo samopoškodovalno vedenje kot simptom pacientove (najpogosteje mladostnikove) motnje in stiske ter ne le kot iskanje pozornosti ali način vplivanja na vedenja drugih. Želeli smo poučiti osebje zdravstvene nege o ustreznem ocenjevanju pacientove ogroženosti ob samopoškodovanju in s tem nudenju najustreznejše pomoči v trenutkih, ko jo najbolj potrebuje. Z raziskavo je bilo ugotovljeno sledeče: Več kot 50 % zaposlenih v zdravstveni negi, vključenih v prvi del raziskave meni, da ima premalo znanja o samopoškodovalnem vedenju. Pri tem je močno željo po izobraževanju izražalo več kot 75 % anketiranih. Ob izvajanju aktivnosti zdravstvene nege se največ zaposlenih sooča z občutkom nemoči. Odnos zaposlenih smo opredeljevali na podlagi vrednotenja SHAS lestvice (Self-Harm Antipathy Scale) ter ugotovili, da imajo zaposleni v zdravstveni negi v UPK Ljubljana pozitiven odnos do mladostnikov, ki se samopoškodujejo. V drugem delu raziskave, ki je potekala po izobraževanju, smo ugotovili, da se je na podlagi izobraževanja znanje zaposlenih izboljšalo. V nadaljevanju smo znanje zaposlenih v UPK Ljubljana primerjali z znanjem strokovnih delavcev iz izobraževalnega, socialno varstvenega, zdravstvenega in nevladnega sektorja v Sloveniji. Predvidevali smo, da je znanje zaposlenih v UPK Ljubljana boljše, kar smo potrdili na podlagi rezultatov testiranja hipotez. Vpliva izobraževanja na odnos zaposlenih do pacientov s samopoškodovalnim vedenjem nismo
Keywords:	samopoškodovanje, zdravstvena nega, kakovost, kazalniki kakovosti, znanje, izobraževanje, mladostniki
Place of publishing:	Maribor
Year of publishing:	2016
PID:	20.500.12556/DKUM-64038
COBISS.SI-ID:	7784211
NUK URN:	URN:SI:UM:DK:U31LXMOE
Publication date in DKUM:	12.10.2016
Views:	2037
Downloads:	210
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Categories:	FOV
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Secondary language

Language:	English
Title:	Evaluation of the Effect of Healthcare Staff Knowledge on the Treatment of Youth Exhibiting Self-Harm Behaviors
Abstract:	The phrase non-suicidal self-harming behavior describes the deliberate causing of injury to one's own body in a way that is not socially acceptable and does not have a suicidal purpose. It occurs most frequently during adolescence and brings various positive effects to the individual, principally serving as a means of relieving internal tension. The majority of adolescents who self-harm do so with the aim of calming themselves, relaxing and allowing them to regain control over their emotional distress. The first writings on self-harming behavior are found in the Old Testament and even today it is a common health issue that healthcare workers see ever more frequently at all levels of the healthcare system. Despite this, in Slovenia there is no systematic tracking of self-harming, although it has been determined on the basis of studies carried out abroad that healthcare employees lack knowledge of the etiology of the disorder and its control, which can lead to a lack of understanding and a lack of empathy by employees and consequently a negative effect on the entire treatment process. This master's thesis work is made up of theoretical and empirical work. The theoretical section deals with psychopathological self-harming behavior and the role of healthcare. It also includes a chapter on quality in healthcare and guidance for the development of quality, as well as on the role of employees in introducing changes. Due to a lack of data on self-harming behavior in a hospital environment, we first determined the appearance and means of treatment from the point of view of healthcare at the University Psychiatric Clinic Ljubljana (UPC Ljubljana) on the basis of an internal indicator of quality. In order to help and guide employees, patients and their relatives, we made a small flyer »Self-Harming and Making a Safety Plan« and introduced certain changes on the basis of guidelines by the Ministry of Health and of national principles of quality in the working process. Empirical studies are included at various phases. In the first phase, called the identification of knowledge, feelings and the relationship of healthcare employees during the treatment of patients with self-harming behaviors, we carried out three interviews. On the basis of these interviews and an examination of the studies carried out abroad, a survey questionnaire was made, followed by an extensive study. The data were collected using a quantitative technique, i.e. a self-evaluation questionnaire of a closed type. The survey was carried out in two parts, one before and one after education. On the basis of education, we wished to increase the sensibility of employees so that they would recognize the self-harming behavior as a symptom of patients' (primarily adolescents') disturbance and distress and not simply as attention seeking or as a way of influencing the behavior of others. Our aim was to teach healthcare personnel about the appropriate evaluation of a patient's vulnerability to self-harming and thus to help them offer the most suitable help at the times when it is most needed. This study determined the following: More than 50% of healthcare employees included in the first part of the study thought that they had too little knowledge of self-harming behavior. More than 75% of those surveyed expressed a strong desire for more education. While carrying out their work in healthcare, most employees face a feeling of powerlessness. The relationship between employees and patients was defined on the basis of an evaluation of the Self-Harm Antipathy Scale (SHAS) and we determined that healthcare employees at UPC Ljubljana have positive relations towards adolescents who self-harm. In the second part of the study, which followed the educational part, we determined that the knowledge of employees had strongly improved on the basis of the education. To follow up, we compared the knowledge of employees at UPC Ljubljana to the knowledge of employees in the educational, socia
Keywords:	self-harm, healthcare, quality, indicators of quality, knowledge, educationadolescents

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