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Instituto Nacional de Salud Pública

2020, Number 5

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salud publica mex 2020; 62 (5)

Open communication between mental health professionals and parents of patients with intellectual disabilities

Ángeles-Llerenas A, Domínguez-Esponda R, Katz-Guss G, Astudillo-García CI, Rodríguez-Valentín R, Madrigal-de León E, Salvador-Carulla L, Lazcano-Ponce E

Language: Spanish
References: 46
Page: 494-503
PDF size: 295.45 Kb.


ABSTRACT

Objective. To estimate the factors associated with open communication between mental health professionals and parents of patients with intellectual disabilities and other neurodevelopmental disorders. Materials and methods. Cross-sectional survey in 759 mental health professionals. The association between the pattern of open communication and the attributes of communication was estimated through a logistic, ordinal, multivariate model. Results. The prevalence of the pattern of open communication in mental health professionals was 30.6% (95%CI 27.4-34.0). The associated factors were younger age (RM=2.42, 95% CI 1.57-3.75), specialty (RM= 1.56, 95%CI 1.09-2.23), high value to the truth (RM= 4.95, 95% CI 3.21-7.65), low paternalism (RM= 10.93, 95%CI 7.22-16.52) and courses in bioethics (RM= 1.45, 95%CI 1.01-2.09), adjusted for confusing variables. Conclusion. Mental health professionals reported low levels of open communication with parents of people with neurovelopmental disorders, so prioritizing the value to the truth, promoting less paternalism, and respecting the autonomy of patients, can contribute to changing these patterns of communication in clinical practice in Mexico.


REFERENCES

  1. Lazcano-Ponce E, Angeles-Llerenas A, Alvarez-del Rio A, Salazar- Martinez E, Allen B, Hernandez-Avila M, et al. Ethics and communication between physicians and their patients with cancer, HIV/AIDS, and rheumatoid arthritis in Mexico. Arch Med Res. 2004;35(1):66-75. https://doi. org/10.1016/j.arcmed.2003.06.007

  2. Ahmed R, Borst JM, Yong CW, Aslani P. Do parents of children with attention- deficit/hyperactivity disorder (ADHD) receive adequate information about the disorder and its treatments? A qualitative investigation. Patient Prefer Adherence. 2014;8:661-70. https://doi.org/10.2147/PPA.S60164

  3. Sciberras E, Iyer S, Efron D, Green J. Information needs of parents of children with attention-deficit/hyperactivity disorder. Clin Pediatr (Phila). 2010;49(2):150-7. https://doi.org/10.1177/0009922809346730

  4. Hummelinck A, Pollock K. Parents’ information needs about the treatment of their chronically ill child: a qualitative study. Patient Educ Couns. 2006;62(2):228-34. https://doi.org/10.1016/j.pec.2005.07.006

  5. Coulter A, Entwistle V, Gilbert D. Sharing decisions with patients: is the information good enough? BMJ. 1999;318(7179):318-22. https://doi. org/10.1136/bmj.318.7179.318

  6. Narayan S, Hay J. Cost effectiveness of methylphenidate versus AMP/DEX mixed salts for the first-line treatment of ADHD. Expert Rev Pharmacoecon Outcomes Res. 2004;4(6):625-34. https://doi. org/10.1586/14737167.4.6.625

  7. Clay D, Farris K, McCarthy AM, Kelly MW, Howarth R. Family perceptions of medication administration at school: errors, risk factors, and consequences. J Sch Nurs. 2008;24(2):95-102. https://doi.org/10.1177/105 98405080240020801

  8. de Castro F, Vazquez-Salas RA, Villalobos A, Rubio-Codina M, Prado E, Sanchez-Ferrer JC, et al. Context and results of early childhood development in 12 to 59 months old children living in Mexico. Salud Publica Mex. 2019;61(6):775-86. https://doi.org/10.21149/10560

  9. Suarez-Lopez L, de Castro F, Hubert C, de la Vara-Salazar E, Villalobos A, Hernandez-Serrato MI, et al. Maternal and child healthcare and adolescent maternity in under 100 000 inhabitants communities. Salud Publica Mex. 2019;61(6):753-63. https://doi.org/10.21149/10551

  10. Saturno-Hernandez PJ, Poblano-Verastegui O, Flores-Hernandez S, Angel-Garcia D, O’Shea-Cuevas GJ, Villagran-Munoz VM, et al. Quality care indicators for neonates with selected pathologies: pilot study. Salud Publica Mex. 2019;61(1):35-45. https://doi.org/10.21149/9271

  11. Gupta M. Values-based practice and bioethics: close friends rather than distant relatives. Commentary on ‘Fulford (2011). The value of evidence and evidence of values: bringing together values-based and evidence-based practice in policy and service development in mental health’. J Eval Clin Pract. 2011;17(5):992-5. https://doi.org/10.1111/j.1365-2753.2011.01734.x

  12. Gibert SH, DeGrazia D, Danis M. Ethics of patient activation: exploring its relation to personal responsibility, autonomy and health disparities. J Med Ethics. 2017;43(10):670-5. https://doi.org/10.1136/medethics- 2017-104260

  13. Traner CB, Tolchin DW, Tolchin B. Medical ethics education for neurology residents: where do we go from here? Semin Neurol. 2018;38(5):497- 504. https://doi.org/10.1055/s-0038-1667381

  14. Schmetzer AD, Lafuze JE, Jack ME. Overcoming stigma: involving families in medical student and psychiatric residency education. Acad Psychiatry. 2008;32(2):127-31. https://doi.org/10.1176/appi.ap.32.2.127

  15. Perez-Stable E. Issues in Latino health care. West J Med. 1987;146(2):213-8. https://www.ncbi.nlm.nih.gov/pubmed/3825120

  16. Quesada GM. Language and communication barriers for health delivery to a minority group. Soc Sci Med. 1976;10(6):323-7. https://doi. org/10.1016/0037-7856(76)90078-0

  17. Garcia-Gonzalez A, Gonzalez-Lopez L, Gamez-Nava JI, Rodriguez- Arreola BE, Cox V, Suarez-Almazor ME. Doctor-patient interactions in Mexican patients with rheumatic disease. J Clin Rheumatol. 2009;15(3):120-3. https://doi.org/10.1097/RHU.0b013e31819d89bf

  18. Angeles-Llerenas A. Patrones de comunicación de profesionales de la salud con los padres de sujetos con TDI, TEA y TDAH [internet]. figshare [citado abril 13, 2020]. https://doi.org/10.6084/m9.figshare.12115644.v1

  19. Scior K, Grierson K. Service provision for young people with intellectual isabilities and additional mental health needs: service-providers’ perspectives. J Appl Res Intellect Disabil. 2004;17:173-9. https://doi. org/10.1111/j.1468-3148.2004.00193.x

  20. Jacobs M, Downie H, Kidd G, Fitzsimmons L, Gibbs S, Melville C. Mental health services for children and adolescents with learning disabilities: a review of research on experiences of service users and providers. Br J Learn Disabil. 2016;44(3):225-32. https://doi.org/10.1111/bld.12141

  21. Ong N, McCleod E, Nicholls LE, Fairbairn N, Tomsic G, Lord B, et al. Attitudes of healthcare staff in the treatment of children and adolescents with intellectual disability: A brief report. J Intellect Dev Dis. 2016;42(3):295-300. https://doi.org/10.3109/13668250.2016.1236368

  22. Low LF, McGrath M, Swaffer K, Brodaty H. Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners. Dementia (London). 2019;18(7-8):2856-905. https://doi.org/10.1177/1471301218761911

  23. Velan B, Ziv A, Kaplan G, Rubin C, Connelly Y, Karni T, et al. Truth-telling and doctor-assisted death as perceived by Israeli physicians. BMC Med Ethics. 2019;20(1):13. https://doi.org/10.1186/s12910-019-0350-5

  24. Voorhees J, Rietjens J, Onwuteaka-Philipsen B, Deliens L, Cartwright C, Faisst K, et al. Discussing prognosis with terminally ill cancer patients and relatives: a survey of physicians’ intentions in seven countries. Patient Educ Couns. 2009;77(3):430-6. https://doi.org/10.1016/j.pec.2009.09.013

  25. Honeycutt C, Sleath B, Bush PJ, Campbell W, Tudor G. Physician use of a participatory decision-making style with children with ADHD and their parents. Patient Educ Couns. 2005;57(3):327-32. https://doi.org/10.1016/j. pec.2004.09.004

  26. Falkum E, Forde R. Paternalism, patient autonomy, and moral deliberation in the physician-patient relationship. Attitudes among Norwegian physicians. Soc Sci Med. 2001;52(2):239-48. https://doi.org/10.1016/s0277- 9536(00)00224-0

  27. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681-92. https://doi.org/10.1016/s0277-9536(96)00221-3

  28. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49(5):651-61. https://doi.org/10.1016/s0277-9536(99)00145-8

  29. Gustafson DL, Brunger F. Ethics, “Vulnerability,” and feminist participatory action research with a disability community. Qual Health Res. 2014;24(7):997-1005. https://doi.org/10.1177/1049732314538122

  30. Thompson GA, Whiffen LH. Can physicians demonstrate high quality care using paternalistic practices? a case study of paternalism in Latino physician-patient interactions. Qual Health Res. 2018;28(12):1910-22. https://doi.org/10.1177/1049732318783696

  31. Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, et al. Challenges in end-of-life care in the ICU. Statement of the 5th International Consensus Conference in Critical Care: Brussels, Belgium, April 2003. Intensive Care Med. 2004;30(5):770-84. https://doi.org/10.1007/s00134-004-2241-5

  32. Frosch DL, Kaplan RM. Shared decision making in clinical medicine: past research and future directions. Am J Prev Med. 1999;17(4):285-94. https://doi.org/10.1016/s0749-3797(99)00097-5

  33. Halgunseth LC, Ispa JM, Rudy D. Parental control in Latino families: an integrated review of the literature. Child Dev. 2006;77(5):1282-97. https:// doi.org/10.1111/j.1467-8624.2006.00934.x

  34. Macklin R. Against relativism: Cultural diversity and the search for ethical universals in medicine. Oxford: Oxford University Press, 1999.

  35. Enzinger AC, Zhang B, Schrag D, Prigerson HG. Outcomes of prognostic disclosure: associations with prognostic understanding, distress, and relationship with physician among patients with advanced cancer. J Clin Oncol. 2015;33(32):3809-16. https://doi.org/10.1200/JCO.2015.61.9239

  36. Wang DC, Peng X, Guo CB, Su YJ. When clinicians telling the truth is de facto discouraged, what is the family’s attitude towards disclosing to a relative their cancer diagnosis? Support Care Cancer. 2013;21(4):1089-95. https://doi.org/10.1007/s00520-012-1629-y

  37. Fletcher JF. Morals and medicine: the moral problems of the patient’s right to know the truth, contraception, artificial insemination. Princeton: Princeton University Press, 2015.

  38. Sarafis P, Tsounis A, Malliarou M, Lahana E. Disclosing the truth: a dilemma between instilling hope and respecting patient autonomy in everyday clinical practice. Glob J Health Sci. 2013;6(2):128-37. https://doi. org/10.5539/gjhs.v6n2p128

  39. Rosenberg AR, Starks H, Unguru Y, Feudtner C, Diekema D. Truth Telling in the setting of cultural differences and incurable pediatric illness: a review. JAMA Pediatr. 2017;171(11):1113-9. https://doi.org/10.1001/ jamapediatrics.2017.2568

  40. Julivia-Murtani B, Wibowo JA, Liu CA, Rusady-Goey M, Harsono K, Mardani AAP, et al. Knowledge/understanding, perception and attitude towards attention-deficit/hyperactivity disorder (ADHD) among community members and healthcare professionals in Indonesia. Asian J Psychiatr. 2020;48:101912. https://doi.org/10.1016/j.ajp.2019.101912

  41. Hirfanoglu T, Soysal AS, Gucuyener K, Cansu A, Serdaroglu A. A study of perceptions, attitudes, and level of knowledge among pediatricians towards attention-deficit/hyperactivity disorder. Turk J Pediatr. 2008;50(2):160-6. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/ 18664081

  42. Sajith SG, Chiu J, Wong W, Chiam PC. Perceptions of psychiatry residents and non-residents on training needs and care related to patients with intellectual disability and mental health problems: A study from Singapore. J Intellect Dev Disabil. 2019;44(1):73-80. https://doi.org/10.3109 /13668250.2017.1310811

  43. Reinblatt SP, Rifkin A, Castellanos FX, Coffey BJ. General psychiatry residents’ perceptions of specialized training in the field of mental retardation. Psychiatr Serv. 2004;55(3):312-4. https://doi.org/10.1176/appi. ps.55.3.312

  44. Ruedrich S, Dunn J, Schwartz S, Nordgren L. Psychiatric resident education in intellectual disabilities: one program’s ten years of experience. Acad Psychiatry. 2007;31(6):430-4. https://doi.org/10.1176/appi.ap.31.6.430

  45. Politi MC, Street RL Jr. The importance of communication in collaborative decision making: facilitating shared mind and the management of uncertainty. J Eval Clin Pract. 2011;17(4):579-84. https://doi.org/10.1111/ j.1365-2753.2010.01549.x

  46. Barry MJ. Health decision aids to facilitate shared decision making in office practice. Ann Intern Med. 2002;136(2):127-35. https://doi. org/10.7326/0003-4819-136-2-200201150-00010




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