Objectives: This study aimed to (1) examine barriers and enablers to General Practitioners' (GP) use of National Institute for Health and Care Excellence (NICE) guidelines for self-harm and (2) recommend potential intervention strategies to improve implementation of them in primary care.

Design: Qualitative interview study.

Methods: Twenty-one telephone interviews, semi-structured around the capabilities, opportunities and motivations model of behaviour change (COM-B), were conducted with GPs in the United Kingdom. The Theoretical Domains Framework was employed as an analytical framework. Using the Behaviour Change Wheel, Behaviour Change Techniques (BCTs), intervention functions and exemplar interventions were identified.

Results: GPs valued additional knowledge about self-harm risk assessments (knowledge), and communication skills were considered to be fundamental to high-pressure consultations (cognitive and interpersonal skills). GPs did not engage with the guidelines due to concerns that they would be a distraction from patient cues about risk during consultations (memory, attention and decision processes), and perceptions that following the guidance is difficult due to time pressures and lack of access to mental health referrals (environmental context and resources). Clinical uncertainty surrounding longer term care for people that self-harm, particularly patients that are waiting for or cannot access a referral, drives GPs to rely on their professional judgement over the guidance (beliefs about capabilities).

Conclusions: Three key drivers related to information and skill needs, guideline engagement and clinical uncertainty need to be addressed to support GPs to be able to assess and manage self-harm. Five intervention functions and ten BCT groups were identified as potential avenues for intervention design.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790562PMC
http://dx.doi.org/10.1111/bjhp.12598DOI Listing

Publication Analysis

Top Keywords

behaviour change
12
theoretical domains
8
domains framework
8
intervention functions
8
clinical uncertainty
8
self-harm
5
gps
5
examining drivers
4
drivers self-harm
4
self-harm guideline
4

Similar Publications

Factors associated with higher caregiver burden among informal caregivers of Parkinson's disease: A systematic review.

Medicine (Baltimore)

January 2025

Department of Cardiovascular Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.

Background: Parkinson's disease is a progressive neurodegenerative disease and the care burden in informal caregivers is huge. Summarizing factors associated with the informal caregivers burden can improve our understanding of providing proactive support to informal caregivers caring for patients with Parkinson's disease (PwP) at risk, and provides evidence for clinical practice.

Methods: PRISMA guidelines were followed in this systematic review.

View Article and Find Full Text PDF

Background: Results on parental burden during the COVID-19 pandemic are predominantly available from nonrepresentative samples. Although sample selection can significantly influence results, the effects of sampling strategies have been largely underexplored.

Objective: This study aimed to investigate how sampling strategy may impact study results.

View Article and Find Full Text PDF

Background: There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings.

Objective: The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting.

View Article and Find Full Text PDF

Digital Mindfulness Training for Burnout Reduction in Physicians: Clinician-Driven Approach.

JMIR Form Res

January 2025

Brown University, Department of Behavioral and Social Sciences, Providence, RI, United States.

Background: Physician burnout is widespread in health care systems, with harmful consequences on physicians, patients, and health care organizations. Mindfulness training (MT) has proven effective in reducing burnout; however, its time-consuming requirements often pose challenges for physicians who are already struggling with their busy schedules.

Objective: This study aimed to design a short and pragmatic digital MT program with input from clinicians specifically to address burnout and to test its efficacy in physicians.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!