What motivates to medicate? : a qualitative study exploring the factors that influence a parent's decision to select psycho-stimulants as first-line treatment for their ADHD child.

Abstract

This research seeks to explore and identify the factors that influence a parent’s decision to initiate psycho-stimulant treatment for their ADHD child. It is the intention of this research to gain insight into how parents make decisions about treatment for their child with ADHD and specifically, what motivates a parent to medicate. A qualitative methodological approach was employed. This research is informed by a critical, interpretive approach. An extended personal interview was conducted, using a semi-structured interview guide, with ten parents of ADHD diagnosed children. Children with comorbid conditions (both psychological and medical) were excluded from the sample to control for drug interaction mediating treatment choice. Sample selection included a combination of purposive, quota and snowball sampling techniques. The Health Belief Model and the Theory of Planned Action provide a useful theoretical framework guiding the analysis of data. Findings show that factors influencing the decision making process include: The information parents have and where that information comes from; the role of the teacher in the identification of issues; ADHD being the observer’s interpretation of the child’s behaviour and the beliefs, attitudes and perceptions parents hold regarding all aspects of ADHD. Factors that motivate a parent to choose medication in treating their child diagnosed with ADHD include: The failure of alternatives including their inconsistent treatment effects; having faith in the expert opinion of the prescribing doctor; being encouraged to ‘just try it’; a specific defining moment triggering a cue to action and pressure from a variety of sources. Conclusions of this research confirm there are many diverse factors that influence both the decision making process of parents as well as a definitive decision to choose psycho-stimulants as treatment and that there is no single factor that can be identified as a motivator to medicate. Other conclusions made include: Parents make ADHD treatment decisions based on misinformation from unqualified sources; diagnosis of ADHD remains contentious; the beliefs, attitudes and perceptions parents hold of ADHD and its treatment options play a role in their decision making process but these beliefs, attitudes and perceptions may be related to the misinformation parents have regarding aspects of ADHD and the decision to initiate stimulant treatment is both complicated and intricately related to the individual experiences. Identifying and understanding the factors that motivate treatment decisions can assist physicians and other healthcare professionals in addressing the concerns parents have in managing ADHD. In addition to this, an awareness of the factors influencing parental decisions regarding medication magnifies the important role healthcare professionals have in providing accurate and current information to parents and families when they are faced with making decisions about treatment for their child with ADHD.