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Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care

El-Alti, Leila; Sandman, Lars; Munthe, Christian

Authors

Lars Sandman

Christian Munthe



Abstract

The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: “Fundamental Variability in Patient Capacity”, “Patient Participation: Narration or Compliance?”, “Antagonism Rooted in Power Struggles”, and “System Structure Thwarts Patient Release”. While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress.

Citation

El-Alti, L., Sandman, L., & Munthe, C. (2022). Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care. PLOS ONE, 17(9), Article e0275205. https://doi.org/10.1371/journal.pone.0275205

Journal Article Type Article
Acceptance Date Sep 13, 2022
Online Publication Date Sep 29, 2022
Publication Date 2022
Deposit Date Oct 5, 2022
Publicly Available Date Oct 5, 2022
Journal PLOS ONE
Print ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 17
Issue 9
Article Number e0275205
DOI https://doi.org/10.1371/journal.pone.0275205
Public URL http://researchrepository.napier.ac.uk/Output/2926530

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





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