Research Proposal

Ashford University

Introduction

This study was an exploration of live experience about antipsychotic youth. It entailed use of interpretative qualitative phenomenology study about the youth who have had a recent experience in the taking of antipsychotics. A staged qualitative approach was used for the analysis of transcribed data where approximately, 13 hours of the audio of young people ages 13-26 was collected between January – August, 2010. For people suffering from severe mental illness such as psychotic disorders, antipsychotics are the main therapy for them, regardless of the controversies regarding their effectiveness and safety on patients (Alessi-Severini, et al., 2012). However, not much has been done to explore the experiences of young people on antipsychotics.

With some information still available on youths’ perceptions towards the effects of antipsychotics on their bodies, thoughts, behaviors and hopes, there is further need to understand its effect on their cognitions, social functioning and emotions (Alessi-Severini, et al., 2012). This understanding can be of great value especially for patient advocates, policy makers and clinicians. This paper thus reports its findings from a phenomenological analysis perspective on the experiences of young people with use of antipsychotics.

Sampling strategy

This study utilized a purposeful recruitment process where youths of age 11-25 years with a mental illness prescribed with more than one antipsychotic for the past two years were targeted with literature and clinical experiences defining the recruitment process. Interpretive phenology was used as a result of a commitment to ideography and a desire to achieve more understanding of contextual phenomena. For this study, 24 participants were recruited, though typically higher than what is typically needed due to participants’ possible cognitive issues (Benner, 2005). The aim of using interpretive phenomenological analysis is to examine the lived experience in a certain situation where the researcher is to make sense of a participant who also makes sense out of their own experience (Hamann, et al., 2009).

Data collection and analysis

The research utilized use of semi-structured interview guides administered by one individual. A list of generic and brand names on pyschotropics and antipsychotics were included where both the interviewer and the interviewee determined the kind of medications discussed through the list (Floersch, 2003). This proceeded with the recording, transcribing and analysis of the data. Anonymity was achieved through use of false initials where a participant requested not to be recoded.

Data collection begun on January and ended on August, 2010 where 18 interviews (13 audio hours) had been conducted in general for youths aged 13-25 years owing to the richness of the data gathered. The analysis followed a staged iterative and inductive approach with participants being sent findings and themes for their review and comments for member-checking, community knowledge translation (KT), and data triangulation on study findings (Cook, & Jonikas, 2002). In order to make the data credible, dependent and valid, participant opportunity and iterative analysis was used.

Research Findings

The research established out that youths had had an infrequent experience with antipsychotic monotherapy within either the past or currently (Cook, & Jonikas, 2002). These exposure was on several types of psychotropics. Also, according to the way youths described them from their understanding, a range of diagnosis included several symptoms and terminologies from different conditions (Floersch, 2003). The researchers depicted this a “double-edged saw” metaphor, in relation to the antipsychotic youth experience that is either ambivalent, desire of an alternative, support gaps or stigma.

The researchers found out that ambivalence was influenced by support gaps, desire for alternatives and stigma. This also resulted into decisional conflict within the youths. Ambivalence and decisional conflict is then what determined whether a youth will start, continue or stop with use of antipsychotics with both benefits and adverse consequences weighed equally (Hamann, et al., 2009). Adverse effects could impact the mental functioning associated with physical symptoms such weight gain and high blood pressure. These effects were overcome by such strategies such as dose altering, stopping of medications or use of illicit substances.

When it came to a desire for alternatives, there are those who questioned the effectiveness of using antipsychotics with the aim to overcome illness without medications through their own strengths or by using other alternatives such as holistic, natural and herbal remedies. On support gaps, it was evident that participants were not able to contextualize and quantify the risks and benefits of treatments (Hamann, et al., 2009). From some participants, treatment risks could lead to peer support or relationship loss gaps and stigma which is a concern for future disclosures.

Conclusion

The research concluded that for youth on antipsychotics, there is a complexity in the benefits and consequences associated to the same as it affects all life’s facets. Youth also have a significant ambivalence on antipsychotics prescription. As such, there is need for further research to investigate if truly youth understand and can make informed choices before initiating, continuing and discontinuing in use of antipsychotics.

References

Alessi-Severini, S., Biscontri, R. G., Collins, D. M., Sareen, J., & Enns, M. W. (2012). Ten years of antipsychotic prescribing to children: A Canadian population-based study. Canadian Journal of Psychiatry, 57(1), 52-58.

Benner, P. (2005). Quality of life: A phenomenological perspective on explanation, prediction, and understanding in nursing science. Advances in Nursing Science, 8(1), 1-14.

Cook, J. A., & Jonikas, J. A. (2002). Self-determination among mental health consumers/survivors: Using lessons from the past to guide the future. Journal of Disability Policy Studies, 13(2), 88-96. doi: 10.1177/10442073020130020401

Floersch, J. (2003). The subjective experience of youth psychotropic treatment. Social Work in Mental Health, 1(4), 51-69. doi:10.1300/J200v01n04_04

Hamann, J., Mendel, R., Cohen, R., Heres, S., Ziegler, M., Buhner, M., & Kissling, W. (2009). Psychiatrists’ use of shared decision making in the treatment of schizophrenia: Patient characteristics and decision topics. Psychiatric Services, 60(8), 1107-1112.