The Family Meets the Hospital

Costell, Ronald M.; Reiss, David

doi:10.1001/archpsyc.1982.04290040041006

Cited by 14 publications

(3 citation statements)

References 11 publications

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“…Additionally, certain studies have also found that attitudes of family members and their knowledge of the patient's illness contribute to adherence, [9][10][11][12] and that attitudes of the family toward psychotropic medications can influence the attitudes of patients toward these medications. [13][14][15][16] Attitudes held by family members are of particular importance in the Indian context, where there is a greater involvement of the family in all aspects of the patient's care, including the decision to take prescribed medicines. [17] However, the number of studies, which have examined the attitudes among family caregivers, including those from India, is still quite small.…”

Section: Introductionmentioning

confidence: 99%

Attitudes toward psychotropic medications among patients with chronic psychiatric disorders and their family caregivers

Grover

Chakrabarti

Sharma

et al. 2014

Journal of Neurosciences in Rural Practice

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Aim:To examine attitudes towards psychotropic medications among patients with chronic psychiatric disorders as well as their family caregivers by using factor analysis.Materials and Methods:The study included 200 patients and their family caregivers with chronic psychiatric disorders who are attending the psychiatry outpatient services. A self-designed 18-item self-rated questionnaire was used to evaluate the attitude toward psychotropics and factor analysis was done to study the different models of attitudes.Results:In general both patients and caregivers had positive attitude toward the psychotropic medications and there was no significant difference between the patients and caregivers on the various items of the questionnaire assessing the attitude. Factor analysis of the questionnaire indicated that either two-factor or four-factor models explained the attitude of the patients and caregivers. In the two-factor model there was one positive and one negative attitude factor, whereas the four-factor model comprised of two positive and two negative attitude factors. The four-factor model of attitudes provided a more comprehensive solution to how attitudes might be formed among patients and their family caregivers. Factors one and four in the four-factor solution still reflected positive attitudes, but appeared to portray a risk-benefit approach, in which benefits such as the efficacy of psychotropic medications in treating mental illnesses and preventing relapse, and medications being better than other options were being contrasted with the risks of side effects and permanent damage or harm.Conclusion:Attitudes of patients with chronic psychiatric disorders and their caregivers toward psychotropic medications appear to be shaped by factors such as perceived efficacy or benefit from medicines, the necessity for taking treatment and concerns such as side effects, harm or expense.

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Section: Introductionmentioning

confidence: 99%

Attitudes toward psychotropic medications among patients with chronic psychiatric disorders and their family caregivers

Grover

Chakrabarti

Sharma

et al. 2014

Journal of Neurosciences in Rural Practice

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“…Many of the risk factors for noncompliance are associated with less tangible, and more subjective, perceptions and attitudes. Examples include lack of insight (Lin et al 1979), denial of illness (McEvoy et al 1989), stigma (Terkelsen 1985), family belief in medication (Costell et al 1981), perceived quality of the doctor-patient relationship (Davis 1976), perceived benefit from medication (Kelly et al 1987), and perceived distress from side effects (Weiden et al 1989). Despite inherent methodologic difficulties, it seems necessary to evaluate the subjective experience of the schizophrenia patient in order to understand compliance behavior and develop strategies to prevent noncompliance.…”

mentioning

confidence: 99%

Rating of Medication Influences (ROMI) Scale in Schizophrenia

Weiden

Rapkin

Mott

et al. 1994

Schizophrenia Bulletin

262

149

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Noncompliance with neuroleptic treatment is a major barrier to delivery of effective treatment for schizophrenia outpatients. This article describes the development of a standardized measure for the assessment of attitudinal and behavioral factors influencing patient compliance with neuroleptic treatment. The Rating of Medication Influences (ROMI) scale was developed as part of a longitudinal study of neuroleptic noncompliance in schizophrenia and administered to 115 discharged schizophrenia outpatients. Analyses of the following were conducted to assess the scale's psychometric properties: (1) interrater reliability, (2) internal consistency, (3) principal components, (4) correlation with other subjective measures, and (5) correlation with independent family reports. Most (95%) of the ROMI patient-report items were reliable, whereas rater-judgment items were not reliable. The rater section was dropped. A principal components analysis of the reliable patient-report items yielded three subscales related to compliance (Prevention, Influence of Others, and Medication Affinity) and five subscales related to noncompliance (Denial/Dysphoria, Logistical Problems, Rejection of Label, Family Influence, and Negative Therapeutic Alliance). There were significant correlations between these subscales, and independently obtained family-report ROMI items were significant. The Denial/Dysphoria subscale correlated strongly with two other published measures of dysphoric response to neuroleptics, whereas the other noncompliance subscales did not. The ROMI is a reliable and valid instrument that can be used to assess the patient's subjective reasons for medication compliance and non-compliance. The subscale findings suggest that the ROMI provides a more comprehensive data base for patient-reported compliance attitudes than the other available subjective measures. Indications for use of the ROMI and other subjective measures of neuroleptic response are reviewed.

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“…Finally, program evaluation is a critical component of assessing the efficacy of family-oriented psychiatric inpatient care. Costell and Reiss (1982) conducted a study that suggested that fa m i I ies have d iff e re nt experiences, needs, and potential for engagement in hospital treatment. Families with a psychiatrically hospitalized adolescent were classified into four groups.…”

Section: Family-focused In Patientmentioning

confidence: 99%