Shipwright Emily, Murphy David
School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK.
Qual Health Res. 2024 Dec 9:10497323241303391. doi: 10.1177/10497323241303391.
Approximately 2500 people receive electroconvulsive therapy (ECT) annually in the United Kingdom; however, there is growing evidence of long-term adverse effects. Few studies have focused on people's experience of ECT, particularly over the long term. The experience of ECT is known to be complex, requiring qualitative exploration. Therefore, this study aimed to explore the long-term adverse experiences of ECT, including psychological impacts, meaning-making, and coping. Narrative analysis considered thematic, structural, and performative elements of seven people's stories. Themes were explored across the timeline of participants' experiences. Before ECT, participants felt misinformed regarding ECT and misunderstood by healthcare professionals. They noticed immediate changes in their cognition, memory, and mood after ECT. Returning home was important in participants' discovery of differences. Long-term impacts were loss (of ability, memory, humanity, and connection), the realization that ECT had been damaging, and understanding ECT to have caused brain damage. The extensive nature of loss experienced by participants was comparable to the concept of ambiguous loss. They experienced a lack of follow-up care and denial of their experiences, which could contribute to psychological iatrogenic harm. Participants coped with adverse experiences by using prompts and strategies and connecting with others. Further research is needed into the adverse long-term effects of ECT, especially considering cognitive effects, memory loss, and how these contribute to a changed sense of self. Service development is urgently required, especially for ECT follow-up care.
在英国，每年约有2500人接受电休克疗法（ECT）；然而，越来越多的证据表明存在长期不良影响。很少有研究关注人们接受ECT的经历，尤其是长期经历。众所周知，ECT的经历很复杂，需要进行质性探索。因此，本研究旨在探讨ECT的长期不良经历，包括心理影响、意义建构和应对方式。叙事分析考虑了七个人故事的主题、结构和表现元素。在参与者经历的时间线上探索主题。在接受ECT之前，参与者觉得自己得到的关于ECT的信息有误，且被医护人员误解。他们注意到接受ECT后自己的认知、记忆和情绪立即发生了变化。回家对参与者发现差异很重要。长期影响包括（能力、记忆、人性和人际关系方面的）丧失、意识到ECT具有损害性以及理解ECT导致了脑损伤。参与者经历的丧失范围之广与模糊丧失的概念相当。他们经历了缺乏后续护理以及自己的经历被否认的情况，这可能会造成心理医源性伤害。参与者通过使用提示和策略以及与他人建立联系来应对不良经历。需要对ECT的长期不良影响进行进一步研究，尤其是考虑认知影响、记忆丧失以及这些如何导致自我认知的改变。迫切需要开展服务改进，尤其是针对ECT的后续护理。
