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一项关于严重精神疾病患者隐瞒与披露经历及困境的定性研究。

A Qualitative Study Examining Experiences and Dilemmas in Concealment and Disclosure of People Living With Serious Mental Illness.

作者信息

Bril-Barniv Shani, Moran Galia S, Naaman Adi, Roe David, Karnieli-Miller Orit

机构信息

1 University of Haifa, Haifa, Israel.

2 Ben-Gurion University of the Negev, Beer Sheva, Israel.

出版信息

Qual Health Res. 2017 Mar;27(4):573-583. doi: 10.1177/1049732316673581. Epub 2016 Oct 24.

Abstract

People with mental illnesses face the dilemma of whether to disclose or conceal their diagnosis, but this dilemma was scarcely researched. To gain in-depth understanding of this dilemma, we interviewed 29 individuals with mental illnesses: 16 with major depression/bipolar disorders and 13 with schizophrenia. Using a phenomenological design, we analyzed individuals' experiences, decision-making processes, and views of gains and costs regarding concealment and disclosure of mental illness. We found that participants employed both positive and negative disclosure/concealment practices. Positive practices included enhancing personal recovery, community integration, and/or supporting others. Negative practices occurred in forced, uncontrolled situations. We also identified various influencing factors, including familial norms of sharing, accumulated experiences with disclosure, and ascribed meaning to diagnosis. Based on these findings, we deepen the understanding about decision-making processes and the consequences of disclosing or concealing mental illness. We discuss how these finding can help consumers explore potential benefits and disadvantages of mental illness disclosure/concealment occurrences.

摘要

患有精神疾病的人面临着是否披露或隐瞒其诊断结果的困境,但这一困境几乎未得到研究。为了深入了解这一困境,我们采访了29名患有精神疾病的个体:16名患有重度抑郁症/双相情感障碍,13名患有精神分裂症。采用现象学设计,我们分析了个体关于隐瞒和披露精神疾病的经历、决策过程以及对收益和成本的看法。我们发现,参与者采用了积极和消极的披露/隐瞒做法。积极做法包括促进个人康复、融入社区和/或支持他人。消极做法发生在被迫、无法控制的情况下。我们还确定了各种影响因素,包括家庭分享规范、披露的累积经验以及对诊断的归因意义。基于这些发现,我们加深了对决策过程以及披露或隐瞒精神疾病后果的理解。我们讨论了这些发现如何帮助患者探索披露/隐瞒精神疾病的潜在利弊。

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