The Patient’s Diagnosis: Explanatory Models of Mental Illness

Abstract

The purpose of the study was to develop a grounded theory about individuals' perception of the situation of being a psychiatric patient. Thirty-five inpatients (19 males, 16 females), ages 18 to 68, in two psychiatric units of an urban, public facility were interviewed on a biweekly basis from admission to discharge. Data were analyzed using the constant comparative method, and the data indicated that participants used the basic social process of managing self-worth to deal with the stigmatizing social predicament of being a mental patient. Events occurring before admission that shaped their responses were substance abuse, medication noncompliance, and the lack of social capital, which led to norm violations and subsequent hospitalization. Six attribution categories emerged: problem, disease, crisis, punishment, ordination, and violation. Findings support the need for professionals to improve their practice by acknowledging the effects of patients' subjective assessments on their response to hospitalization and by placing more emphasis on assisting patients to deal with the stigmatizing effects of a psychiatric diagnosis.

A Qualitative Exploration of Service Users’ Information Needs and Preferences When Receiving a Serious Mental Health Diagnosis

“…During the interview, open-ended questions and a reflective process of inquiry were used to aid the participants in illustrating their diagnostic communication desires based on their experiences. In line with previous qualitative research with mental health participants the interviewer checked for understanding and simplified any statements requiring further explanation (Sayre 2000). Interviews were audio taped with an average length of 40 min.…”

Older primary care patient views regarding antidepressants: A mixed methods approach

“…All study protocols were approved by the Institutional Review Board of the University of Pennsylvania. The interviews were designed to give participants an opportunity to express their views about depression and depression treatment (Kleinman, 1980; Sayre, 2000). …”

Explanatory Models and Help-Seeking Behavior: Pathways to Psychiatric Care Among Patients Admitted for Depression in Mulago Hospital, Kampala, Uganda

“…This clinical approach reinforces the denial of the personal reality and meaning of mental illness. As a result, patients often find that hospitalization has not helped them to understand what has happened (Sayre, 2000). The altered sense of self and the unusual experiences that occur, especially if depression is associated with psychotic features, place the individual in what has been termed an undifferentiated predicament (Barham & Hayward, 1995), which the individual must then interpret and manage.…”