Sharing Decisions in Consultations in Involving Anti-Psychotic Medication : A Qualitative Study of Psychiatrists' Experiences  

Oleh:

Seale, Clive ; Chaplin, Robert ; Lelliott, Paul ; Quirk, Alan

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 11 (Jun. 2006), page 2861-2873.
Topik: PSYCHIATRY; psychitary; antipsychotic medication; schizophrenia; psychosis; decision making; concordance; UK

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.4 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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In psychiatry an in treating people with a diagnosis of schizophrenia in particular, there are obstacles to achieveing concordant, shared decision making and in building a co-operative therapeutic alliance where mutual honesty is the norm. Studies of people with a diagnosis of schizophrenia have revealed critical views of medical authority, particulalrly over the issue of enforced compliance with antipsychotic medication. Psychiatrists are known to place particular value on such medication. This qualitative study reports the views of 21 general adult psychiatrists working in UK about their experiences of consultations involving discussion of antipsychotic medication. Interviewees reported a general commitment to achieveing concordant trelationships with patients and described a number of strategies they used to promote this. In this respect, their self perception differs from the picture of authoritarian practice painted by critics of psychiatry, and by some studies reporting patients' views. Interviewes also descrbed obstacles to achieving concordance, including adverse judgements of patients' competence and honesty about their medication use. Explaining the adverse effects of medication was perceived to discourage some patients from accepting this treatment. Moments of stretgic dishonesty were reported. Psychiatrists perceived that trust could be damaged by episodes of coercion, or by patients' perpception of coercive powers. We conclyude that a self perception of patient centredness may not preclude psychiatrists from fullfilling a social control function.

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