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Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care

The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities an...

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Autores principales: El-Alti, Leila, Sandman, Lars, Munthe, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521939/
https://www.ncbi.nlm.nih.gov/pubmed/36174093
http://dx.doi.org/10.1371/journal.pone.0275205
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author El-Alti, Leila
Sandman, Lars
Munthe, Christian
author_facet El-Alti, Leila
Sandman, Lars
Munthe, Christian
author_sort El-Alti, Leila
collection PubMed
description The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: “Fundamental Variability in Patient Capacity”, “Patient Participation: Narration or Compliance?”, “Antagonism Rooted in Power Struggles”, and “System Structure Thwarts Patient Release”. While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress.
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spelling pubmed-95219392022-09-30 Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care El-Alti, Leila Sandman, Lars Munthe, Christian PLoS One Research Article The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: “Fundamental Variability in Patient Capacity”, “Patient Participation: Narration or Compliance?”, “Antagonism Rooted in Power Struggles”, and “System Structure Thwarts Patient Release”. While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress. Public Library of Science 2022-09-29 /pmc/articles/PMC9521939/ /pubmed/36174093 http://dx.doi.org/10.1371/journal.pone.0275205 Text en © 2022 El-Alti et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
El-Alti, Leila
Sandman, Lars
Munthe, Christian
Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title_full Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title_fullStr Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title_full_unstemmed Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title_short Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
title_sort caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521939/
https://www.ncbi.nlm.nih.gov/pubmed/36174093
http://dx.doi.org/10.1371/journal.pone.0275205
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