DISCUSSION OF RESULTS
4.3 FACTORS THAT INFLUENCE THE DECISION MAKING PROCESS
4.3.5 PARENTAL BELIEFS, ATTITUDES AND PERCEPTIONS
Working through the transcribed interviews, it is clear that each individual interviewed had their own unique experience. Every parent described their individual encounters with their child’s teacher, with the diagnosing medical professional and with significant others.
In addition to this, these experiences are further differentiated as a result of the personal beliefs, attitudes and perceptions parents hold. Some of these personal and unique attributes were expressed more directly than others. For some, the perception of ADHD was a label that meant there was something wrong with their child, for others the term ADHD equated to medication. Two of the parents interviewed were
skeptical as to whether or not ADHD really existed, believing it to be a useful term adopted to give a name to a more challenging child.
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Findings indicate that a parent’s beliefs, perceptions and attitudes regarding teachers, medical
professionals, ADHD as a disorder and modern society, are reflected in their decision making process.
This can be illustrated in the following:
Respondent 3 does not know what causes ADHD and explains ADHD as
‘…a condition which means you lack concentration and focus, you are easily distracted, constantly lose and forget things and take a long time to complete things’.
In the case of respondent 3, it was the child’s teacher who first raised concerns about behaviour and a visit to the doctor was the result of being called in for repeated parent / teacher meetings:
‘…the whole process was very much driven by the teacher. It certainly didn’t come from me. I wasn’t the one who kept saying there’s a problem’.
In addition to this, this parent’s attitude towards ADHD is that:
‘…it’s not like something you do a blood test for, have concrete evidence for and then take meds for’…it isn’t like we were told your son has x, like if he were to have some major illness. It was more like he was just struggling with certain things’.
Following several parent / teacher meetings and doctor consults which culminated in Ritalin being prescribed, the parent chose natural supplements (as a source of second opinion) as their initial preferred treatment approach. When this treatment approach did not yield satisfactory results (as per constant teacher feedback), the decision was taken to medicate. The child has now been on medication daily for 2 years (first 10mg Ritalin and now 36mg Concerta). Despite receiving very positive feedback from the teacher, no longer getting called in for parent / teacher meetings and no longer being told the child isn’t coping, this parent’s attitude towards medication is reflected in the following:
‘Every month I hate buying it. Every month I ask myself if it is really necessary. I don’t think I will ever go and buy it willingly’.
It is clear from the detail above that the beliefs, attitudes and perceptions of this parent are significant factors influencing the treatment decision making process.
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It is however necessary to be cognizant of the fact that these factors may be influential on both a conscious and / or subconscious level – individuals are often not aware of their personal underlying beliefs, attitudes or perceptions that influences thought processes and actions taken and the extent to which these inform a treatment decision.
It is also necessary to consider how beliefs, attitudes and perceptions shape, and are shaped by, our state of knowledge. This parent had no information regarding causes of ADHD yet expresses some definite
opinions on a variety of topics. This parent was not given any reading material by the doctor and used casual conversations with others to extend knowledge. In addition to this, parents also have opinions as to the effectiveness of alternative treatments, eight out of the ten participants had very skeptical views on natural supplements – a general attitude towards over the counter supplements was that they were ‘a waste of time’. What informs the beliefs, attitudes and perceptions we hold? Answering this question is beyond the scope of this study but if we consider the case of respondent 3 detailed above, a pertinent question is raised: if this respondent had accurate, reliable information relating to what ADHD is, etiology, diagnosis, treatment alternatives and the specifics as to how they work, what effect would this have on the beliefs, attitudes and perceptions of the individual whose responsibility it is to make a treatment decision?
It is important that health professionals have a greater awareness of the personal experiences and concerns of treatment decision makers as misinformed individual may then hold distorted beliefs, misguided
perceptions and disproportionate attitudes influencing their decision making process.
In seeking to understand the factors that influence the decision making processes of parents, findings suggest that there is no one, single factor that influences this process. However, some of the factors which are significant influencers include: the knowledge one has of the disorder in terms of a general
understanding of the disorder, etiology, diagnosis and treatment; information sources accessed; the role the teacher plays both in initiating intervention and in assessing effectiveness of the selected treatment; the degree to which parents are accepting of the diagnosis and the personal beliefs, attitudes and perceptions of the decision maker.
The focus of discussion now specifically moves onto factors that motivate to medicate.
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An analysis of the transcribed interviews reveals some significant themes which provide us with insight into the factors that motivate a parent to choose medication in treating their child diagnosed with ADHD.
Discussion of each of these relevant themes follows: