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Qualitative Health Research
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*Choosing a Doctor or Health Care Service
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Analysis of Accident and Emergency Doctors' Responses to Treating People Who Self-Harm

Jo Hadfield

Berkshire Healthcare NHS Foundation Trust, Wokingham, Berkshire, United Kingdom

Dora Brown

University of Surrey, Guildford, Surrey, United Kingdom

Louise Pembroke

London, United Kingdom

Mark Hayward

University of Surrey, Guildford, Surrey, United Kingdom

Self-harm is a prevalent phenomenon regularly faced by doctors and nurses working in accident and emergency (A&E) departments. We argue that the treatment decisions A&E doctors make are fundamental to decreasing the high risk of suicide among this group. In this article we present a qualitative study exploring how doctors working in A&E respond to treating people who self-harm. In total, five A&E doctors were interviewed and the data were analyzed using interpretative phenomenological analysis. Three main themes were extracted: treating the body, silencing the self, and mirroring cultural and societal responses to self-harm. Within these themes, we identified both facilitative and unhelpful aspects of the relationships between people who self-harm and A&E doctors. We consider the clinical implications of these findings within the context of A&E doctors having limited opportunities to address the relational nature of the care they offer to this group.

Key Words: care • acute • emergency room • health care • provider perspective and behavior • hermeneutic phenomenology • interpretative methods • interpretative phenomenological analysis (IPA) • relationships • health care • self-harm

Qualitative Health Research, Vol. 19, No. 6, 755-765 (2009)
DOI: 10.1177/1049732309334473
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