Articles producció científica> Antropologia, Filosofia i Treball Social

The collaborative management of antipsychotic medication and its obstacles: A qualitative study

  • Identification data

    Identifier: imarina:6389784
  • Authors:

    Martínez-Hernáez Á
    Pié-Balaguer A
    Serrano-Miguel M
    Morales-Sáez N
    García-Santesmases A
    Bekele D
    Alegre-Agís E
  • Others:

    Author, as appears in the article.: Martínez-Hernáez Á; Pié-Balaguer A; Serrano-Miguel M; Morales-Sáez N; García-Santesmases A; Bekele D; Alegre-Agís E
    Department: Antropologia, Filosofia i Treball Social
    URV's Author/s: Alegre Agís, Elisa / Martinez Hernaez, Angel
    Keywords: Therapeutic alliance Schizophrenia Qualitative research Psychosis Outcomes Mental health Experience Concordance Collaborative management of medication Coercion Catalonia Autonomous medication Antipsychotic medication qualitative research mental health concordance collaborative management of medication coercion catalonia antipsychotic medication
    Abstract: © 2020 Elsevier Ltd Antipsychotic medication is the primary treatment for psychotic conditions such as schizophrenia and schizoaffective disorders; nevertheless, its administration is not free from conflicts. Despite taking their medication regularly, 25–50% of patients report no benefits or perceive this type of treatment as an imposition. Following in the footsteps of a previous initiative in Quebec (Canada), the Gestion Autonome de la Médication en Santé Mentale (GAM), this article ethnographically analyses the main obstacles to the collaborative management of antipsychotics in Catalonia (Spain) as a previous step for the implementation of this initiative in the Catalan mental healthcare network. We conducted in-depth interviews with patients (38), family caregivers (18) and mental health professionals (19), as well as ten focus groups, in two public mental health services, and patients' and caregivers' associations. Data were collected between February and December 2018. We detected three main obstacles to collaboration among participants. First, different understanding of the patient's distress, either as deriving from the symptoms of the disorder (professionals) or the adverse effects of the medication (patients). Second, differences in the definition of (un)awareness of the disorder. Whereas professionals associated disorder awareness with treatment compliance, caregivers understood it as synonymous with self-care, and among patients “awareness of suffering” emerged as a comprehensive category of a set of discomforts (i.e., symptoms, adverse effects of medication, previous admissions, stigma). Third, discordant expectations regarding clinical communication that can be condensed in the differences in meaning between the Spanish words “trato” and “tratamiento”, where the first denotes having a pleasant manner and agreement, and the second handling and management. We conclude that these three obstacles pave the way for coercive practices and promote patients' de-subjectivation, named here as the “total patient” effect. This study is the first GAM initiative in Europe.
    Thematic Areas: Sociología Social sciences, biomedical Serviço social Saúde coletiva Public, environmental & occupational health Psychology Psicología Planejamento urbano e regional / demografia Odontología Nutrição Medicine (miscellaneous) Medicina ii Medicina i Interdisciplinar History and philosophy of science Historia y filosofía de la ciencia Health (social science) General o multidisciplinar General medicine Farmacia Enfermagem Educação física Economia Ciencias sociales Ciencias humanas Ciências biológicas i Ciências ambientais Ciência da computação Antropologia / arqueologia
    ISSN: 02779536
    Author's mail: elisa.alegre@urv.cat angel.martinez@urv.cat elisa.alegre@urv.cat
    Author identifier: 0000-0003-3720-7163 0000-0002-5122-7075 0000-0003-3720-7163
    Record's date: 2024-06-15
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://www.sciencedirect.com/science/article/abs/pii/S0277953620300307
    Papper original source: Social Science & Medicine. 247 (112811): 112811-
    APA: Martínez-Hernáez Á; Pié-Balaguer A; Serrano-Miguel M; Morales-Sáez N; García-Santesmases A; Bekele D; Alegre-Agís E (2020). The collaborative management of antipsychotic medication and its obstacles: A qualitative study. Social Science & Medicine, 247(112811), 112811-. DOI: 10.1016/j.socscimed.2020.112811
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1016/j.socscimed.2020.112811
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2020
    Publication Type: Journal Publications
  • Keywords:

    Health (Social Science),History and Philosophy of Science,Medicine (Miscellaneous),Public, Environmental & Occupational Health,Social Sciences, Biomedical
    Therapeutic alliance
    Schizophrenia
    Qualitative research
    Psychosis
    Outcomes
    Mental health
    Experience
    Concordance
    Collaborative management of medication
    Coercion
    Catalonia
    Autonomous medication
    Antipsychotic medication
    qualitative research
    mental health
    concordance
    collaborative management of medication
    coercion
    catalonia
    antipsychotic medication
    Sociología
    Social sciences, biomedical
    Serviço social
    Saúde coletiva
    Public, environmental & occupational health
    Psychology
    Psicología
    Planejamento urbano e regional / demografia
    Odontología
    Nutrição
    Medicine (miscellaneous)
    Medicina ii
    Medicina i
    Interdisciplinar
    History and philosophy of science
    Historia y filosofía de la ciencia
    Health (social science)
    General o multidisciplinar
    General medicine
    Farmacia
    Enfermagem
    Educação física
    Economia
    Ciencias sociales
    Ciencias humanas
    Ciências biológicas i
    Ciências ambientais
    Ciência da computação
    Antropologia / arqueologia
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