Managing deliberate self harm patients: knowledge and practices among hospital doctors in Galle district

Introduction

Deliberate Self-Harm (DSH) has emerged as an important health issue in Sri Lanka. It is one of the strongest risk fac­tors for completed suicides.

 

Methods:

A questionnaire based descriptive cross-sectional study with a qualitative component was done in three hospitals in Galle district, in Southern Sri Lanka. Selection of variables was done by reviewing selected literature and curricula of basic training of medical officers. A series of in depth interviews were conducted to supplement the findings by using purposive sampling. Multivariate analysis was done to determine factors associated with satisfactory level of performances. Qualitative data analysis was done for in depth interviews.

 

Results:

Overall knowledge and practices were shown to be satisfactory but deficiencies were noted in certain aspects. Male gender (OR 3.560) and having a work experience of <5 years (OR 6.184) showed significantly higher level of knowl­edge while age<30 years (OR 4.497) showed satisfactory level of practices. Lack of priority given for psychiatric care stood as the main barrier in delivering satisfactory care. Excess work load, lack of competency and inadequate train­ing appeared to be contributory factors.

 

Conclusions:

More training opportunities on psychiatric management DSH patients should be included. Competencies on prelimi­nary risk assessments and providing basic psychological support should be improved.