Koopowitz Leslie Frank, Chur-Hansen Anna, Reid Sally, Blashki Miriam
Department of Psychiatry, University of Adelaide, South Australia, Australia.
Aust N Z J Psychiatry. 2003 Feb;37(1):49-54. doi: 10.1046/j.1440-1614.2003.01108.x.
Despite the vast amount of scientific literature available on electroconvulsive therapy (ECT), there is little qualitative focus upon the patients' subjective experience of this procedure. Using an exploratory descriptive methodology, this study aims to provide a more unique insight into what certain patients actually think of ECT.
Semistructured interviews were conducted to explore eight patients' opinions and experiences of ECT. Interviews were subjected to analysis by a five-step framework approach that identified prominent themes in relation to five broad questions and in conjunction with issues raised by the subjects themselves.
Eleven major themes were identified. Four of these were chosen for discussion, not only as the most prevalent themes (in terms of how frequently they were mentioned by the subjects), but also as the most striking (in regards to the intensity of emotions evoked, or their influence on their perception of ECT as a future treatment option). The four themes are fear of ECT, attribution of cognitive decline and memory loss to ECT, positive ECT experiences, and patients' suggestions.
Using such a qualitative approach, the depth of the information obtained has revealed new perspectives on how patients perceive the experience of ECT. Fears reported by patients present an opportunity to address specific areas of the procedure that generate the most angst. These were closely associated with recommendations that many patients proposed throughout the interviews. Patients' perceptions of the cognitive effects of ECT do not necessarily correspond with those commonly reported in the literature on ECT. Positive experiences with ECT were more complex than simply its efficacy. There is a need for future research in order to explore and address patients' experiences of ECT.
尽管有大量关于电休克疗法(ECT)的科学文献,但对于该治疗过程中患者的主观体验却鲜有定性研究。本研究采用探索性描述方法,旨在更深入地了解特定患者对ECT的真实看法。
进行半结构化访谈,以探究8名患者对ECT的看法和体验。访谈采用五步框架分析法进行分析,该方法结合五个广泛问题以及受试者自身提出的问题,确定突出主题。
共确定了11个主要主题。其中四个主题被选作讨论内容,这不仅是因为它们是最普遍的主题(就受试者提及的频率而言),还因为它们最引人注目(就所引发的情感强度,或其对患者将ECT视为未来治疗选择的认知的影响而言)。这四个主题分别是对ECT的恐惧、将认知衰退和记忆丧失归因于ECT、ECT的积极体验以及患者的建议。
采用这种定性方法,所获得信息的深度揭示了患者对ECT体验认知的新视角。患者报告的恐惧为解决该治疗过程中引发最大焦虑的特定领域提供了契机。这些恐惧与许多患者在访谈中提出的建议密切相关。患者对ECT认知影响的看法不一定与ECT相关文献中通常报道的一致。ECT的积极体验比单纯的疗效更为复杂。未来需要开展研究以探索和解决患者对ECT的体验。