Hassan Lamiece, Edge Dawn, Senior Jane, Shaw Jenny
University of Manchester, Manchester, United Kingdom
University of Manchester, Manchester, United Kingdom.
Qual Health Res. 2015 Jul;25(7):954-65. doi: 10.1177/1049732314554094. Epub 2014 Oct 7.
Psychotropic medicines are widely used to treat mental illness; however, people entering prison commonly report that prescribed psychotropic medicines are changed or withdrawn, adding to their distress in difficult times. Drawing on three extracts from a larger qualitative dataset in which patients and doctors were interviewed about psychotropic medication use in English prisons, we combined discursive psychological and Foucauldian discourse analysis techniques to examine how individuals accounted for medication changes. Patients used four discursive strategies to organize descriptions of medication changes: they established entitlement to psychotropic medication, questioned the clinical judgment of prison doctors; highlighted communication problems; and attributed negative health outcomes to medication regime changes. In contrast, we examined an effective defense by a general practitioner, which showed how clinical needs were prioritized over previously held prescriptions when making prescribing decisions. Wider implications for continuity and equivalence of care between prisons and the wider community are discussed.
精神药物被广泛用于治疗精神疾病；然而，进入监狱的人普遍报告称，所开的精神药物被更改或停用，这加剧了他们在艰难时期的痛苦。我们从一个更大的定性数据集中选取了三段内容，在该数据集中，就英国监狱中精神药物的使用情况对患者和医生进行了访谈，我们结合了话语心理学和福柯式话语分析技术，以研究个人如何解释药物变化。患者使用了四种话语策略来组织对药物变化的描述：他们确立了使用精神药物的权利，质疑监狱医生的临床判断；强调沟通问题；并将负面健康结果归因于药物治疗方案的改变。相比之下，我们研究了一名全科医生的有效辩护，该辩护展示了在做出开药决定时，临床需求如何优先于先前开出的处方。文中还讨论了监狱与更广泛社区之间护理连续性和等效性的更广泛影响。
