Abstract
Objective
This research sought to gain insight into the processes used by clinicians to discuss a schizophrenia diagnosis with patients/families, with the aim of informing the development of a communications skills training program.
Methods
A generic qualitative methodological approach was used. Sixteen mental health clinicians were recruited. Semi-structured individual interviews were used to explore their perceptions and experiences communicating a schizophrenia diagnosis. Interviews were recorded, transcribed, and thematic analysis undertaken.
Results
There were five key themes relating to the process of communication about a diagnosis of schizophrenia: (1) orientation to patient care, (2) planning of communication, (3) the impact of team leadership and inter/intra-professional functioning on communication tasks, (4) the roles of different clinicians in communicating about diagnosis and treatment, and (5) time and resource deficiencies. Despite expressing care and concern for vulnerable patients and embracing the concept of multidisciplinary teams, communicating diagnostic information to patients and families was generally unplanned for, with little consistency regarding leadership approaches, or how the team communicated diagnostic information to the patient and family. This contributed to tensions between different team members.
Conclusion
The findings demonstrated a number of issues compromising good communication around a schizophrenia diagnosis, both in terms of clinician skill and clinical context, and support the importance of education and training for all members of the multidisciplinary team about their role in the communication process.
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Acknowledgments
We thank the clinicians who participated in this study and gave their time and perspectives so generously for the sake of others and the improvement of mental health practices.
Disclosures
There are no conflicts of interest. We confirm all personal identifiers have been removed or disguised so the persons described are not identifiable and cannot be identified through the details of the paper.
This study was supported by an Australian New South Wales Health Education and Teaching Institution (HETI) grant, the University of Newcastle Priority Research Centre for Health Behavior and the Hunter Medical Research Institute.
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Outram, S., Harris, G., Kelly, B. et al. Contextual Barriers to Discussing a Schizophrenia Diagnosis with Patients and Families: Need for Leadership and Teamwork Training in Psychiatry. Acad Psychiatry 39, 174–180 (2015). https://doi.org/10.1007/s40596-014-0226-4
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DOI: https://doi.org/10.1007/s40596-014-0226-4