No description available.

Objective: Describe emergency department (ED) presentations for self-harm by youth (12-17 yearolds), including the mental health follow-up they receive after their first-ever presentation, and analyze the association between this mental health follow-up and repeat presentation(s). Methods: Population-based health services data from Ontario, Canada, covering April 2002 to March 2009, were used to ascertain ED presentations for self-harm by youth (n=16,835). These data were used to create a retrospective cohort (n=3,497) of those making their first-ever presentation, and individually-linked to inpatient admission and ambulatory physician contact data. Mental health follow-up within 30-days of discharge, either from a psychiatrist or from any physician specialty, was assessed. The associations between follow-up and repeat self-harm presentation(s) within the following year were then analyzed. Results: Conservatively, the overall incidence rate for ED presentations for self-harm by Ontario youth was 239.0 per 100,000 person-years. Rates were higher in girls, increased with age and inversely related to neighbourhood income and community size (population). Self-harm made up a small but severe proportion of ED use by youth. Over half (57.2%) making their first-ever self-harm presentation had no mental health contact with a physician within 30 days of discharge (and several demographic, clinical and health service variables were associated with follow-up). However, mental health follow-up was not associated with reduced odds of repetition or fewer repeat presentations. Conclusions: ED presentations for self-harm by youth in Ontario are remarkably consistent with those reported from other Western countries. Self-harm is an important public health issue in Canada and requires a comprehensive prevention strategy. These data suggested follow-up youth received after their first-ever ED presentation for self-harm may be inadequate and strategies to improve follow-up may be needed. Still, more research is needed to establish the effect of follow-up on relevant outcomes.

Objective: Describe emergency department (ED) presentations for self-harm by youth (12-17 yearolds), including the mental health follow-up they receive after their first-ever presentation, and analyze the association between this mental health follow-up and repeat presentation(s). Methods: Population-based health services data from Ontario, Canada, covering April 2002 to March 2009, were used to ascertain ED presentations for self-harm by youth (n=16,835). These data were used to create a retrospective cohort (n=3,497) of those making their first-ever presentation, and individually-linked to inpatient admission and ambulatory physician contact data. Mental health follow-up within 30-days of discharge, either from a psychiatrist or from any physician specialty, was assessed. The associations between follow-up and repeat self-harm presentation(s) within the following year were then analyzed. Results: Conservatively, the overall incidence rate for ED presentations for self-harm by Ontario youth was 239.0 per 100,000 person-years. Rates were higher in girls, increased with age and inversely related to neighbourhood income and community size (population). Self-harm made up a small but severe proportion of ED use by youth. Over half (57.2%) making their first-ever self-harm presentation had no mental health contact with a physician within 30 days of discharge (and several demographic, clinical and health service variables were associated with follow-up). However, mental health follow-up was not associated with reduced odds of repetition or fewer repeat presentations. Conclusions: ED presentations for self-harm by youth in Ontario are remarkably consistent with those reported from other Western countries. Self-harm is an important public health issue in Canada and requires a comprehensive prevention strategy. These data suggested follow-up youth received after their first-ever ED presentation for self-harm may be inadequate and strategies to improve follow-up may be needed. Still, more research is needed to establish the effect of follow-up on relevant outcomes.

Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 4 uppsatser.

Thesis (D. Min.)--Boston University, 2001. / Abstract. Includes bibliographical references (leaves 127-132).

Thesis (Ph. D.)--University of North Texas, Dec., 2008. / Title from title page display. Includes bibliographical references.

Thesis (Ph. D.)--Florida State University, 2005. / Advisor: C. Aaron McNeece, Florida State University, College of Social Work. Title and description from dissertation home page (viewed Jan. 24, 2006). Document formatted into pages; contains viii, 90 pages. Includes bibliographical references.

Thesis (D. Min.)--Boston University, 2001. / Abstract. Includes bibliographical references (leaves 127-132).

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Bakgrund: Självskadebeteende är en avsiktlig handling av vävnadsskada genom att rispa, skära eller bränna huden utan avsikt till suicid. I Sverige under 2016 vårdades cirka 6900 personer på sjukhus till följd av avsiktlig destruktiv handling, varav 62 % var kvinnor. Resultat: Kvinnor med självskadebeteende hade ofta växt upp i en otrygg miljö, varit med om trauma eller saknat vuxenstöd. Självskada hade varit ett sätt för att lindra emotionellt lidande och för att kunna fortsätta att leva. Effekten av självskada avtog och blev som ett beroende innan det eskalerade. Känslor av skam, skuld och ensamhet var vanliga. Stigmatisering hindrade hjälpsökande. Bristande bemötande och vård upplevdes. Främjade för tillfrisknad var att behandla bakomliggande orsak till beteendet, finna alternativa åtgärder till att hantera det emotionella och ha ett holistiskt synsätt. Slutsatser: Självskadebeteende har för kvinnor inneburit ett oavbrutet lidande, psykiskt och fysiskt. För sjuksköterskan och övrig vårdpersonal är det viktigt att ha kunskap om orsaker till att kvinnor inte söker hjälp för sitt självskadebeteende för att kunna nå och hjälpa dem. I föreliggande studie framkom att hinder för att söka hjälp hade varit vårdens bristande bemötande och okunskap om självskadebeteendet. Sjuksköterskan behöver ökade kunskaper om självskadebeteendet, sträva efter ett empatiskt bemötande och utföra god holistisk omvårdnad.