Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: cAmbivalent connections: a qualitative study of the care experiences of non-psychotic chronic patients who are perceived as ‘difficult’ by professionals | Koekkoek et al. BMC Psychiatry 2010 10 96 http 1471-244X 10 96 BMC Psychiatry RESEARCH ARTICLE Open Access Ambivalent connections a qualitative study of the care experiences of non-psychotic chronic patients who are perceived as difficult by professionals 3 4 11 Bauke Koekkoek 1 Berno van Meijel Joyce van Ommen Renske Pennings Ad Kaasenbrood Giel Hutschemaekers1 5 Aart Schene6 Abstract Background Little is known about the perspectives of psychiatric patients who are perceived as difficult by clinicians. The aim of this paper is to improve understanding of the connections between patients and professionals from patients point of view. Methods A Grounded Theory study using interviews with 21 patients from 12 outpatient departments of three mental health care facilities. Results Patients reported on their own difficult behaviours and their difficulties with clinicians and services. Explanations varied but could be summarized as a perceived lack of recognition. Recognition referred to being seen as a patient and a person - not just as completely ill or as completely healthy . Also we found that patients and professionals have very different expectations of one another which may culminate in a difficult or ambivalent connection. In order to explicate patient s expectations the patient-clinician contact was described by a stage model that differentiates between three stages of contact development and three stages of substantial treatment. According to patients in each stage there is a therapeutic window of optimal clinician behaviour and two wider spaces below and above that may be qualified as toxic behaviour. Possible changes in clinicians responses to difficult patients were described using this model. Conclusions The incongruence of patients and professionals expectations may result in power struggles that may make professionals perceive patients as difficult . Explication of mutual expectations may be useful in such cases. The presented .
