A qualitative study on the admission experience of patients with first-episode psychosis

Abstract

Background: For early psychosis patients, the first few years were critical period for determining long-term illness outcome. The first experience of admission had significant bearing on the perception of subsequent psychiatric treatment received. From this perspective, it was important to be aware of how patients suffered and how they coped in order to regain their sense of self of insight and treatment adherence and trust with nurses’ rapport and their therapeutic relationship. In this regard, a qualitative study was done with an aim to (i) explore the admission experiences and beliefs participants held upon admission and after discharged within two months. (ii) any influences on their perceptions of experience during and after admission which might impact on therapeutic relationship and treatment attitude

Method: Eight ICD-10 first-episode psychosis (FEP) patients aged between 18 and 55 years who admitted to psychiatric inpatient unit for the management of their FEP were recruited. Two face-to-face in-depth interviews were conducted for each participant. First interview was conducted within 2 weeks of admission, while second interview was conducted during psychiatric outpatient follow-up appointment within two months after discharged from hospital. All interviews were audiotaped and transcribed. Thematic analysis was employed to derive common themes regarding patients’ experience and perception on psychiatric hospitalization for their FEP.

Results: Thematic analysis revealed six main themes regarding patients’ subjective experience and perception on the illness and hospitalization. These were uncontrollable sense of self, supportive relationship with family members, unpleasant admission procedure, and feeling out of control during hospitalization, perceived benefits of admission, and perceived adverse impacts of admission.

Conclusion: Our findings indicated that ideas about what constitute admission perception needed to take into account of patient’s views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of nursing staff.