A Qualitative Study of Caregiver Training in Administration of Psychotherapeutic Medications to Male Foster Children.

摘要

Male foster children residing in higher levels of care were at least five times more likely to be prescribed more than one psychotherapeutic medication concurrently compared to non-foster male children. Seminal research has reflected that side effects from psychotherapeutic drugs have been common among children, and this qualitative phenomenological study was designed to explore current foster care training levels related to the employment knowledge base of primary caregivers to explore the experience with adverse reactions to psychotherapeutic medications by the male foster children. Semi-structured interviews were used to explore whether or not male and female primary caregivers of three group care facilities experienced dissonance and behaviors of medicated male foster children, and how this dissonance may have affected caregiver roles. The findings of this phenomenological study produced five major themes and 12 minor themes, which emerged through qualitative analysis. Themes developed by identifying exactly what was important within the interview comments. The five major themes were (a) feeling underappreciated, (b) inadequate training, (c) inhibited job role, (d) limited insight to efficacy of psychotherapeutic medication, and (e) disassociation to treatment history. Twelve minor themes found were: (a) low pay, (b) stress, (c) overload of duties, (d) lack of professional support, (e) QMAP does not train for side effect identification, (f) QMAP training was not specific to the foster care field, (g) no training in medication other than QMAP, (h) little one-on-one time with residents, (i) negative behaviors as a factor to quitting, (j) little knowledge of mental health care procedures, (k) on medication trends, and (1) lack of resident history impeded caregiver performance. Recommendations for future research included continued qualitative research to utilize (a) grounded theory to determine if caregivers were more invested in seeking independent training to enhance monitoring skills used with medicated male foster children, (b) case study or ethnographic research focused on medicated male foster children to evaluate their perspectives of treatment by the foster care system and understanding of a right to refuse psychotherapeutic medication treatment, and/or (c) ethical inquiry into the study constructs.