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The communication of the diagnosis of schizophrenia. Focus group findings on psychiatrists' point of view

Published online by Cambridge University Press:  18 May 2011

Monica Paccaloni ,
Michela Rimondini ,
Tecla Pozzan  and
Christa Zimmermann
Monica Paccaloni*
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Michela Rimondini
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Tecla Pozzan
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Christa Zimmermann
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
*
Address for correspondence: Dr.ssa M. Rimondini, Dipartimento di Medicina e Sanità Pubblica, Servizio di Psicologia Medica, Università di Verona, P.le L.A. Scuro 10, 37134 Verona. Fax: +39-045-585871 E-mail: michela.rimondini@univr.it
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Summary

Aims – Evidence from the literature show that patients affected by psychosis rarely are informed about their diagnosis and/or involved in the decision making process regarding the therapeutic program. The aim of the present study is to investigate psychiatrists' clinical experiences, beliefs and attitudes towards communicating the diagnosis to patients affected by psychosis. Method – Three focus groups were conducted with 28 psychiatrists of different levels of expertise (10 senior psychiatrists and 18 psychiatrists in training), all working at the South-Verona Community-based Mental Health Service. The group discussions were audiotaped and transcribed. The authors derived different thematic categories which were used by two raters to classify all contributions of the psychiatrists. Results – The main themes of interest which emerged were: experience with the communication of the diagnosis of psychosis and main communication strategies used; obstacles and personal difficulties in giving such information. Conclusions – In the psychiatric setting the disclosure of the diagnosis of psychosis implies different clinical and ethical issues and is felt as highly problematic. These findings suggest a need of psychiatrists to involve the psychotic patient in the information giving process in order to learn his/her informative needs which are the starting point for individually tailored information.

The authors have no potential conflict of interest related to the subject of the paper. No economic support has been received for this study.

Keywords

schizophreniadiagnosisinformation givingfocus group
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 1 , March 2008 , pp. 65 - 76
Copyright
Copyright © Cambridge University Press 2008

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References

Bibliografia

Birchwood, M. (2003). Pathways to emotional dysfunction in first-episode psychosis. British Journal of Psychiatry 182, 373–375.CrossRefGoogle ScholarPubMed
Brooks, E., Fletcher, K. & Wahlstedt, P. (1998). Focus group interviews: assessment of continuing education needs for the advanced practice nurse. Journal of Continuing Education in Nursing 29, 27–31.CrossRefGoogle ScholarPubMed
Chaplin, R. (2000). Psychiatrists can cause stigma too. British Journal of Psychiatry 177, 467.CrossRefGoogle ScholarPubMed
Clafferty, R.A., McCabe, E. & Brown, K.W. (2001). Conspiracy of silence? Telling patients with schizophrenia their diagnosis. Psychiatric Bulletin 25, 336–339.CrossRefGoogle Scholar
Corker, E. (2001). Stigma caused by psychiatrists. British Journal of Psichiatry 178,378–381.Google ScholarPubMed
Dice, L.R. (1945). Measures of the amount of the ecologic association between species. Ecology 26, 297–302.CrossRefGoogle Scholar
Drake, J., Dunn, G., Tarrier, N., Bentall, R., Haddock, G. & Lewis, S. (2007). Insight as a predictor of the outcome of first-episode nonaffective psychosis in a prospective cohort study in England. Journal of Clinical Psychiatry 68(1), 81–86.CrossRefGoogle Scholar
Fenton, W.S. (2003). Shared decision making: a model for the physician-patient relationship in the 21st century? Acta Psychiatrica Scandinavica 107, 401–402.CrossRefGoogle Scholar
Frankel, R.M. & Treger Hourigan, N. (2004). Thirty-five voices in search of an author: What focus groups reveal about patients' experiences in managed care settings. Communication & Medicine 1, 45–58.CrossRefGoogle ScholarPubMed
Green, R.S. & Gantt, A.B. (1987). Telling patients and families the psychiatric diagnosis: a survey of psychiatrists. Hospital & Community Psychiatry 38, 666–668.Google ScholarPubMed
Goossensen, A., Zijlstra, P. & Koopmanschap, M. (2007). Measuring shared decision making processes in psychiatry: skills versus patient satisfaction. Patient Education and Counseling 67, 50–56.CrossRefGoogle ScholarPubMed
Hamann, J., Langer, B., Winkler, V., Busch, R., Cohen, R., Leucht, S. & Kissling, W. (2006). Shared decision making for in-patients with schizophrenia. Acta Psychiatrica Scandinavica 114, 265–273.Google Scholar
Hansson, L. (2006). Determinants of quality of life in people with severe mental illness. Acta Psychiatrica Scandinavica, Supplement No. 429, 46–50.CrossRefGoogle Scholar
Hoffman, B.F. (1981). To tell or not to tell. Schizophrenia Bulletin 7, 369–371.CrossRefGoogle ScholarPubMed
Kappa, C.W. (1968). Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin 70, 2143–2220.Google Scholar
Kent, H. & Read, J. (1998). Measuring consumer participation in mental health services: are attitudes related to professional orientation? International Journal of Social Psychiatry 44, 295–310.CrossRefGoogle ScholarPubMed
Landis, R.J. & Koch, G.G. (1977). The measurement of observer agreement for categorical data. Biometrics 33, 159–174.CrossRefGoogle ScholarPubMed
Lauber, C, Nordt, C, Braunschweig, C. & Rossler, W. (2006). Do mental health professionals stigmatize their patients? Acta Psychiatrica Scandinavica, Supplement No. 429, 51–59.CrossRefGoogle Scholar
Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C, Ferrier, K. & Payne, S. (2001). Preferences of patients for patient centred approach to consultation in primary care: observational study. British Medical Journal 322, 468–472.CrossRefGoogle ScholarPubMed
Macpherson, R., Varah, M., Summerfield, L., Foy, C. & Slade, M. (2003). Staff and patient assessments of need in an epidemiologically representative sample of patients with psychosis-staff and patient assessments of need. Social Psychiatry and Psychiatric Epidemiology 38, 662–667.Google Scholar
Magliano, L., De Rosa, C, Guarneri, M., Cozzolino, P., Marangone, C, Marasco, C, Fiorillo, A., Maj, M. & Gruppo di lavoro (2002). Cause e conseguenze psicosociali della schizofrenia: le opinioni degli operatori dei SSM. Epidemiologia e Psichiatria Sociale 11, 35–44.CrossRefGoogle Scholar
Maguire, P. (1982). Psychiatrists also need interview training. British Journal of Psychiatry 141, 423–424.Google Scholar
McDonald-Scott, P., Machizawa, S. & Satoh, H. (1992). Diagnostic disclosure: a tale in two cultures. Psychological Medicine 22, 147–157.CrossRefGoogle ScholarPubMed
Mead, N., Bower, P. & Hann, M. (2002). The impact of general practitioners' patient-centredness on patients' post-consultation satisfaction and enablement. Social Science and Medicine 55, 283–299.CrossRefGoogle ScholarPubMed
Mintz, A., Dobson, K. & Romney, D. (2003). Insight in schizophrenia: a meta-analysis. Schizophrenia Research 61, 75–88.Google Scholar
Morgan, D. (1997). Focus Groups as Qualitative Research (Qualitative research methods, Vol. 16). Sage Publications: Thousand Oaks C.A.:CrossRefGoogle Scholar
Myers, E.D. & Calvert, E.J. (1984). Information, compliance and sideeffects: a study of patients on antidepressant medication. British Journal of Clinical Pharmacology 17, 21–25.CrossRefGoogle ScholarPubMed
Nordt, C, Rossler, W. & Lauber, C. (2006). Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophrenia Bullettin 32, 709–714.CrossRefGoogle ScholarPubMed
Ono, Y., Satsumi, Y., Kim, Y., Iwadate, T., Moriyama, K., Nakane, Y., Nakata, T., Okagami, K., Sakai, T., Sato, M., Someya, T., Tagagi, S., Ushijima, S., Yamauchi, K & Yoshimura, K. (1999). Schizophrenia: Is it the time to replace the term? Psychiatry and Clinical Neurosciences 53, 335–341.Google Scholar
Paccaloni, M., Pozzan, T. & Zimmermann, C. (2004). Le informazioni ricevute e il coinvolgimento nella cura in psichiatria: cosa pensano i pazienti? Una revisione della letteratura. Epidemiologia e Psichiatria Sociale 13, 270–283.Google Scholar
Paccaloni, M., Moretti, F. & Zimmermann, C. (2005). Le informazioni ricevute e il coinvolgimento nella cura in psichiatria: cosa pensano gli psichiatri? Una revisione della letteratura. Epidemiologia e Psichiatria Sociale 14, 198–216.Google Scholar
Paccaloni, M, Pozzan, T, Rimondini, M & Zimmermann, C. (2006). Knowledge and informative needs of patients with the diagnosis of schizophrenia, explored with focus group methods. Epidemiologia e Psichiatria Sociale 15, 128–137.CrossRefGoogle ScholarPubMed
Prochaska, J. & Di Clemente, C. (1992). Stages of change in the modification of problem behaviors. Progress in Behaviour Modification 28, 183–218.Google ScholarPubMed
Rimondini, M., Del Piccolo, L., Goss, C, Mazzi, M., Paccaloni, M. & Zimmermann, C. (2006). Communication skills in psychiatry residents: how do they handle patient concerns? An application of sequence analysis to interviews with simulated patients. Psychotherapy and Psychosomatics 75, 161–169.Google Scholar
Schulze, B. & Angermeyer, M.C. (2003). Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Social Science & Medicine 56, 299–312.Google Scholar
Seale, C, Chaplin, R., Lelliott, P. & Quirk, A. (2005). Sharing decisions in consultations involving anti-psychotic medication: a qualitative study of psychiatrists' experiences. Social Science and Medicine 62, 2861–2873.CrossRefGoogle ScholarPubMed
Severens, P. (1995). Handbook Concept Mapping. National Centre for Mental Health: Amsterdam: Talcott.Google Scholar
Tarrier, N. & Barrowclough, C. (2003). Professional attitudes to psychiatric patients: a time for change and an end to medical paternalism. Epidemiologia e Psichiatria Sociale 12, 238–241.Google Scholar
Tate, P. (1994). The Doctor's Communication Handbook. Redcliffe Medical Press: New York.Google Scholar
Üçok, A., Polat, A., Sartorius, N., Erkoç, S. & Atakli, C. (2004). Attitudes of psychiatrists toward patients with schizophrenia. Psychiatry and Clinical Neurosciences 58, 89–91.CrossRefGoogle ScholarPubMed
Watt, S (2000). Clinical decision-making in the context of chronic illness. Health Expectations 3, 6–16.CrossRefGoogle ScholarPubMed
Zammuner, V.L. (2003). Il Focus Group. II Mulino: Bologna.Google Scholar
Zwaenepoel, L., Hoorens, V., Peuskens, J. & Laekeman, G. (2006). The “extent of information desired”–scale in psychiatric in-patients: a behavioural approach. Patient Education and Counselling 62, 72–78.Google Scholar