Φαινομενολογική διερεύνηση της βιωμένης εμπειρίας των ψυχικά πασχόντων από τη νόσο τους στην Κύπρο

Abstract

Background: research shows that understanding the problems of people with serious mental illness (SMI) is difficult for health professionals to achieve. As a result, people with mental health problems do not show confidence in healthcare professionals and in the provided services. Aim: The exploration of mentally ill patients’ perceptions and meanings regarding: a) their illness, in total, b) their self-image throughout their illness, c) the lived social implications following their illness and d) the quality of the inter personal therapeutic relationship with mental health nurses/health professionals. Design & Method: A qualitative methodological approach based on Van Manen was employed. The sample which was selected through purposive sampling and based on theoretical saturation, consisted with 10 people with serious mental illness, that they were recruited from a Day Center in a district of Cyprus. Data collection was conducted via personal interviews. Interviews were based on a semi structured interview guide, which was based on literature and was tested for the suitability of each question by a panel of experts. Results: As the core theme of the lived experience of serious mental illness epi-genesis of the personality and of gain of a new prospective of life, was revealed. This seemed to relate to an internal process and to propose the result of the totality of the individual’s disease course and the lengthy period of trying to accept the effectiveness and the necessity of medication, as well as the nature of the disease and its limitations. In addition, six main themes and several subthemes were described. As far as the meaning of mental illness, the following subthemes were defined: a) the selection of pseudonym, b) the unbearable mental illness, c) mental illness as an external entity towards the person, d) the causes of mental illness, while as far as the pharmacotherapy: a) the different phases of illness in time with pharmacotherapy as a bookmark, b) the necessity of pharmacotherapy, c) reasons for stopping pharmacotherapy. In addition, as far as the perception of personal image through the continuum of illness, the following were identified: a) the perception of personal image within the context of illness, b) the different aspects of the individual’s entity through the continuum of illness and the consequent change of it’s personal image, c) the fragmented individuals status within the context of the illness, d) the perception of personal value and personal abilities through the continuum of the illness: the unpleasant change in the perception of one’s personal image. As far as the consequences due to the illness, those seemed to be the result, either of the social stigma (social devaluation of the personal value, due to low self-esteem, due to deteriorating personal and romantic life, due to deteriorating professional and career life, social life and financial life), while other losses due to the nature of the illness were mainly referred to the dimensions of a) social life, b) personal life and c) professional life and education. Other main themes concerned the Community Mental Health Services (a means for happiness and safety and the traumatic experience of hospitalization (Athalassa Hospital), and the relationship with mental health nurses (a dynamic relationship with Mental Health Nurses, the degree of satisfaction of the provided nursing care) and participants need to be heard. Conclusions: This study highlights the importance of changing the way in which the personality of the person was functioning and existed before the onset of serious mental illness and its treatment, in order for the sufferer to obtain a notion of normality. This data could enhance the formation of targeted Cognitive Behavioral Intervention for the mentally ill. Furthermore, within the current study, the importance of empowerment interventions of the self-identity emerged, which seems to express the different phases of illness and its therapy. Additionally, it has emerged the way a person perceives his personal image throughout the different phases of the illness. Overall, the findings appeared to contribute to the enhancement of the health professional’s empathy in relation to the individual’s needs, based on the fact that new perspectives of such experience. In addition, further intervention studies of limiting mental illness stigma, both in social level and in relation to health professionals in total, are considered to be essential.