What is the process by which a decision to administer electroconvulsive therapy (ECT) or not is made? A grounded theory informed study of the multi-disciplinary professionals involved.



Duxbury, Anna, Smith, Ian, Mair-Edwards, Bethan, Bennison, Gerry, Irving, Kerry, Hodge, Suzanne ORCID: 0000-0003-0416-8188, Anderson, Ian and Weatherhead, Stephen
(2018) What is the process by which a decision to administer electroconvulsive therapy (ECT) or not is made? A grounded theory informed study of the multi-disciplinary professionals involved. Social psychiatry and psychiatric epidemiology, 53 (8). 785 - 793.

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Abstract

PURPOSE:To develop a grounded theory-informed model explaining the decision-making process professionals in multi-disciplinary teams go through in deciding whether to administer electroconvulsive therapy (ECT) or not. METHODS:A grounded theory informed methodology was used to analyse the data offered by ten participants who had all been involved in the process of deciding if someone has ECT or not. RESULTS:The core categories, described as 'layers' in this research, 'personal and professional identity'; 'subjective vs objective'; 'Guidelines or Clinical Instinct?'; 'Someone has to take Responsibility' and 'the decision in action', were constructed from the data. CONCLUSIONS:The study describes a useful insight into the layers of the decision-making process that could be further considered in clinical settings. The model highlights the decision to give ECT that has many different layers including professional identity, how a person understands the evidence base, past experiences, and the amount of power they have in the process. The consultant psychiatrist and the patient were seen as holding most power in the process depending on whether the Mental Capacity Act (2005) or Mental Health Act (2007) was being followed. Patients were seen to experience a very different decision-making process dependant on the personal views of the professionals in relation to ECT.

Item Type: Article
Uncontrolled Keywords: Humans, Electroconvulsive Therapy, Health Personnel, Patient Care Team, Female, Male, Grounded Theory, Clinical Decision-Making
Depositing User: Symplectic Admin
Date Deposited: 04 Apr 2019 15:46
Last Modified: 25 Nov 2019 22:25
DOI: 10.1007/s00127-018-1541-y
URI: http://livrepository.liverpool.ac.uk/id/eprint/3035830
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