PubMed · 14369362
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R J THORNHILL. 1955. Prescribers' notes.. https://pubmed.ncbi.nlm.nih.gov/14369362/
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All child psychiatrists' interactions with patients and families have important potential meanings, and the act of prescribing medication is no exception. As psychopharmacologic practice has increased in child psychiatry, facility with psychotherapeutic skills, such as establishing an alliance, identifying and treating symptoms, and promoting adherence must follow to enhance clinical outcomes. This article addresses the role of the therapeutic alliance in pediatric work, the psychologic implications of administering medications, developmental issues altering psychopharmacologic efforts, the role of the dual alliance (allying both patients and parents), and recommendations for clinical practice and further research.
INTRODUCTION: The role of emotions in GPs' prescribing has been ignored. The present article describes 20 GPs' reflections about what precedes comfort and discomfort in prescribing situations. MATERIALS AND METHODS: In-depth interviews were done with 20 GPs who contributed with examples on an open comfort-discomfort scale. Analysis of the data was inspired by grounded theory. RESULTS: The GPs experienced a broad spectrum of emotions when prescribing. In every prescribing situation, conditions could pull towards both comfort and discomfort. Comfort appeared when the indication was correct and the patient's condition was serious, when the patient experienced the problem as serious, when the situation was acute and the medicine effective, and when the GP experienced himself as competent. Medicines were placed between comfort and discomfort when prescribing was perceived as indifferent, unproblematic and easy, when the GP was concerned about inflicting a sick role on the patients, and when patients were not convinced about the appropriateness of the medication. Discomfort appeared when there was a great risk of dependence, when GPs experienced and gave in to pressure, when they had to convince patients, and when they prescribed addictive medicine regularly. The totality of conditions in the situation determined the emotional state in the prescribing situation. DISCUSSION: The GPs' emotions reflected how they evaluated the appropriateness of their prescribing. This should be taken advantage of in rational pharmacotherapy. Future interventions should address both the rationality of GPs and their emotions.
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