An interview with Dr Rex Bowering, Central Island Child and Adolescent Psychiatry, Nanaimo talks about breaking news of a diagnosis of schizophrenia to the patient and family as well as the important issues of quality of life and goal setting.
When you know that your patient has schizophrenia – is it difficult for you to give them this news? Why is that? Is it the same with their caregiver?
It is only difficult from the point of view that I know what the patient and the family are going to face. I see the patient and their family as they are right now, but it’s a life-long condition, and I know how difficult it is for them to navigate through our system and I know that it can be difficult for patients to make treatment decisions. It’s absolutely essential to involve caregivers in the discussions. It’s important to have the family on board and that they are ready, with everyone on the same page.
What does autonomy/functioning and quality of life for your patients with schizophrenia mean?
Quality of life is as important for a person with this type of diagnosis as it is for anybody. But we do know that the quality of life for someone with this diagnosis is in jeopardy. So it’s very important for all of us working with these individuals to know how quality of life can be negatively affected and to try to help the patient and family minimize the impact. And it’s not just quality of life – it’s function and productivity and goals that they have which are all affected and threatened.
What role do you think your patients should have in defining their own treatment goals?
An essential role. If we choose to define goals for them, we are going to make a mistake or be an obstacle to reaching those goals. We have to help patients to elucidate what their goals might be, and when we know what those are, we are much more likely to help them achieve what they are reaching for. We’ve heard that throughout this conference (APA) over and over. In order to get where you want to be, you need to know where you’re heading. So we help people to define their goals, be realistic about them and support them in their endeavours to get there. It’s all part of the big package.