A qualitative study using a constructivist grounded theory approach to investigate factors in Jordan that impact psychiatric medication-taking behaviour in schizophrenia and Bipolar I disorder

Obiedate, Khaldoon Mohammad

Abstract

Introduction:
Medication-taking behaviour remains a challenging issue in mental health settings. It is widely understood that most people with mental disorders do not take their medications as prescribed. This behaviour is moderated by many factors that influence the decision-making process regarding taking, giving, and prescribing psychiatric medications. Most studies on this topic in Jordan have used quantitative methods. However, these studies failed to explain the medication-taking behaviour toward psychiatric medication or address issues related to people with mental disorders and their families. To my knowledge, this is the first qualitative study in Jordan to investigate medication-taking behaviour among people with schizophrenia or bipolar I disorder from three different perspectives (service users, primary caregivers, and healthcare professionals).
Aim:
This study aimed to explore the factors that influence medication-taking behaviour among Jordanians diagnosed with schizophrenia or bipolar disorders and how these factors affect their decision to take their medications, with the specific objective of developing a theory that provides an understanding of the factors that impact taking psychiatric medications. The research question to be answered was “What are the factors that impact psychiatric medication-taking behaviour of service users, primary caregivers, and healthcare professionals' experiences and perspectives? How do these factors influence their taking behaviour?”
Methods:
A qualitative study used an adapted constructivist grounded theory approach supplemented by an analytical approach from the Straussian school. The study was conducted in three settings in Jordan: two mental health outpatient clinics and one community centre. Seventeen participants (n=17) were divided into three groups (six service users, four primary caregivers, and seven healthcare professionals -doctors and nurses) recruited for the study. Data were gathered through semi-structured interviews exploring participants’ views, experiences, knowledge, and beliefs about psychiatric medication taking, giving, and prescribing using online Zoom meetings and audiotape. These were transcribed and coded using constant comparative analysis.
Findings:
This study identified the factors that influence psychiatric medication-taking behaviour. Five categories emerged (experience with psychiatric medications, knowledge about psychiatric disorders and medications, beliefs about psychiatric disorders and medications, health care systems and policies, and financial These categories highlight the major barriers and facilitators to taking, giving, or prescribing psychiatric medications in mental health settings in Jordan. This finding suggests that most service users and primary caregivers either took psychiatric medications as prescribed or stopped taking them. Experience with psychiatric medications highlights the most important factor that impacts psychiatric medication taking as well as the impact on their decision-making.
Discussion:
A key element is that service users and primary caregivers are willing to take their psychiatric medications as prescribed when they have a positive experience and good knowledge about mental disorders and medications in addition to family support, although negative beliefs about mental disorders spread in the community. The undeveloped healthcare system will meet their needs for mental health issues that impact their decision to visit the mental health setting because of the infrastructure of the psychiatric clinic, understaffing, crowded clinics, and medication not being available most of the time because the mental health service is free at the governmental clinic.
Conclusion:
These categories are facilitators or barriers for psychiatric medication-taking behaviour as well as internal and external factors because they interrelate and intersect with each other in many areas that impact the service user and primary caregivers' decision-making process to take psychiatric medication as prescribed or not based on these factors. This decision will later add to their motivation or barriers as well as internal and external factors. Additionally, these factors affect healthcare professionals when psychiatric medications are prescribed to service users. Therefore, service users, primary caregivers, and healthcare professionals should work together, considering the substantive theory developed to weigh the risks and benefits of psychiatric medications based on internal and external factors and build up their decisions.
Contribution of the findings:
Taking medications as prescribed in individuals with severe mental illness is influenced by various factors, which differ between the Middle Eastern and Western contexts. It is important to note that previous research has predominantly focused on the Western context. This study sheds light on Middle Eastern countries, especially Jordan, as this is the first qualitative study in Jordan that explores the factors that impact taking medications as prescribed from the perspective of service users and primary caregivers, which will help in developing interventions based on the cultural context which different from the western cultural context. Also, this study highlights an issue regarding Jordanian drugs versus international medications.

Citation

Obiedate, K. M. A qualitative study using a constructivist grounded theory approach to investigate factors in Jordan that impact psychiatric medication-taking behaviour in schizophrenia and Bipolar I disorder. (Thesis). University of Hull. https://hull-repository.worktribe.com/output/4625339

• Thesis Type: Thesis
• Deposit Date: Apr 15, 2024
• Publicly Available Date: Jun 10, 2024
• Keywords: Nursing
• Public URL: https://hull-repository.worktribe.com/output/4625339
• Related Public URLs: Department of Nursing; University of Hull
• Award Date: Feb 13, 2024