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Medicine taking decisions: schizophrenia in comparison to asthma and epilepsy

Authors

  • G. R. MARLAND rmn rnt dip n bed mn pgcrm phd,

    Corresponding author
    1. Senior Lecturer, Bell College, School of Health Studies, Crichton University Campus, Dudgeon House
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  • K. CASH rmn rgn ba msc phd

    1. Professor, Leeds Metropolitan University, Faculty of Health and Social Studies, Queen Margaret Square, Leeds, UK
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G. R. Marland, Bell College, School of Health Studies, Crichton University Campus, Dudgeon House DG1 4ZN, UK, E-mail: g.marland@bell.ac.uk

Abstract

This paper outlines a recent PhD study that explored factors underpinning decisions of people with schizophrenia regarding neuroleptic medicine taking. Relevant studies tend to be within the world view of psychiatry, resting on traditional concepts of compliance and insight. These studies examined schizophrenia outwith the context of other illnesses taking a snap shot view of medicine taking decision making, thus de-emphasizing its process. The chosen method of grounded theory (Glaser and Strauss 1967) overcomes these deficiencies. Stage 1 data arose from patient interviews, patients with asthma, epilepsy and schizophrenia contributed (n = 45), carers also sometimes contributed (n = 11), all three conditions being episodic disorders vulnerable to environmental stressors. Stage 2 develops from stage 1, mental health workers involved in the care of people with schizophrenia were interviewed, plus one asthma specialist and one epilepsy specialist (n = 16). Their views were compared to perspectives arising from the patient interviews and were included in the data, out of which an explanatory typology emerged. The three parts of the typology comprise the study's major categories and are labelled as: direct-reactive, deferential-compliant, and active discerning and optimizing. Active discerning and optimizing consists of two stages; experimental-reflective and consolidation. The core category of responsive resolution contains themes which run through all major categories.

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