Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa

 

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dc.contributor.advisor Lewis, Ian
dc.contributor.advisor Bantjes, Jason
dc.contributor.author Grobler, Kathryn
dc.date.accessioned 2021-08-04T14:26:16Z
dc.date.available 2021-08-04T14:26:16Z
dc.date.issued 2021
dc.identifier.citation Grobler, K. 2021. Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa. . ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. http://hdl.handle.net/11427/33703 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/33703
dc.description.abstract Background: Suicidal behaviour is increasingly widespread in South Africa and constitutes a significant burden of disease, often within resource-constrained hospital settings. Little is known about the factors associated with psychiatric admission following an act of deliberate self-harm (DSH) in South Africa. Aim: The aim of this study was to investigate the sociodemographic and clinical factors which differentiated DSH patients who were admitted to an emergency psychiatric unit compared to those who were treated in the emergency department and discharged. Setting: Data were collected for 272 consecutive patients presenting to the emergency department of a tertiary, public, urban hospital in South Africa, as a result of self harm, between 16 June 2014 and 29 March 2015, for an initial epidemiological study of DSH at the hospital. This study had a data subset of 174 of those patients (84 admitted to the emergency psychiatric unit and 90 treated in the emergency department and discharged). Methods: This study was a retrospective cross-sectional analysis, and it analysed existing data from the epidemiological study, using bivariate and multivariate logistic regression analysis. Results: Of the patients admitted to the emergency psychiatric unit, a greater proportion of patients were female (61,9%), were not in a relationship (83,3%), had no dependents (60,7%), were unemployed (73,8%), and had a low socioeconomic status (59,5%). Having dependants was associated with an increased likelihood of admission to the emergency psychiatric unit in bivariate analysis; however, when controlling for other sociodemographic variables, this was no longer significant. None of the clinical variables were significantly associated with admission to the emergency psychiatric unit. Conclusion: The lack of significant findings in the sociodemographic and clinical factors associated with an admission to the emergency psychiatric unit (compared to being treated in the emergency department and discharged) is surprising. At face value, it suggests that there are no obvious differences between the two groups. The use of a validated screening tool or more accurate measure of the clinical correlates (e.g. screening tool for substance-related 6 disorders) could have better highlighted, perhaps subtle, differences between the two groups. It is perhaps more important to question whether the perceived risk factors in DSH patients are associated with suicidal behaviour and whether emergency psychiatric unit admission, based on these factors, is more effective at treating DSH short-term, and reducing suicidal behaviour long-term, than say outpatient-based treatment interventions. Clinician-related factors that influence psychiatric admission decisions following DSH is also an important area for future research.
dc.subject patient factors
dc.subject psychiatric admission
dc.subject hospitalisation
dc.subject deliberate self-harm
dc.subject suicide attempt
dc.title Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa
dc.type Master Thesis
dc.date.updated 2021-08-04T14:25:26Z
dc.language.rfc3066 eng
dc.publisher.faculty Faculty of Health Sciences
dc.publisher.department Department of Psychiatry and Mental Health
dc.type.qualificationlevel Masters
dc.type.qualificationlevel MMed
dc.identifier.apacitation Grobler, K. (2021). <i>Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa</i>. (). ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. Retrieved from http://hdl.handle.net/11427/33703 en_ZA
dc.identifier.chicagocitation Grobler, Kathryn. <i>"Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa."</i> ., ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2021. http://hdl.handle.net/11427/33703 en_ZA
dc.identifier.vancouvercitation Grobler K. Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa. []. ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33703 en_ZA
dc.identifier.ris TY - Master Thesis AU - Grobler, Kathryn AB - Background: Suicidal behaviour is increasingly widespread in South Africa and constitutes a significant burden of disease, often within resource-constrained hospital settings. Little is known about the factors associated with psychiatric admission following an act of deliberate self-harm (DSH) in South Africa. Aim: The aim of this study was to investigate the sociodemographic and clinical factors which differentiated DSH patients who were admitted to an emergency psychiatric unit compared to those who were treated in the emergency department and discharged. Setting: Data were collected for 272 consecutive patients presenting to the emergency department of a tertiary, public, urban hospital in South Africa, as a result of self harm, between 16 June 2014 and 29 March 2015, for an initial epidemiological study of DSH at the hospital. This study had a data subset of 174 of those patients (84 admitted to the emergency psychiatric unit and 90 treated in the emergency department and discharged). Methods: This study was a retrospective cross-sectional analysis, and it analysed existing data from the epidemiological study, using bivariate and multivariate logistic regression analysis. Results: Of the patients admitted to the emergency psychiatric unit, a greater proportion of patients were female (61,9%), were not in a relationship (83,3%), had no dependents (60,7%), were unemployed (73,8%), and had a low socioeconomic status (59,5%). Having dependants was associated with an increased likelihood of admission to the emergency psychiatric unit in bivariate analysis; however, when controlling for other sociodemographic variables, this was no longer significant. None of the clinical variables were significantly associated with admission to the emergency psychiatric unit. Conclusion: The lack of significant findings in the sociodemographic and clinical factors associated with an admission to the emergency psychiatric unit (compared to being treated in the emergency department and discharged) is surprising. At face value, it suggests that there are no obvious differences between the two groups. The use of a validated screening tool or more accurate measure of the clinical correlates (e.g. screening tool for substance-related 6 disorders) could have better highlighted, perhaps subtle, differences between the two groups. It is perhaps more important to question whether the perceived risk factors in DSH patients are associated with suicidal behaviour and whether emergency psychiatric unit admission, based on these factors, is more effective at treating DSH short-term, and reducing suicidal behaviour long-term, than say outpatient-based treatment interventions. Clinician-related factors that influence psychiatric admission decisions following DSH is also an important area for future research. DA - 2021 DB - OpenUCT DP - University of Cape Town KW - patient factors KW - psychiatric admission KW - hospitalisation KW - deliberate self-harm KW - suicide attempt LK - https://open.uct.ac.za PY - 2021 T1 - Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa TI - Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa UR - http://hdl.handle.net/11427/33703 ER - en_ZA


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