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Identifying fallacious arguments in a qualitative study of antipsychotic prescribing in dementia

机译:识别痴呆症抗精神病特定的定性研究中的谬论争论

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Background Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings. Fallacious arguments have the potential to become unremarkable discourses that construct and validate practices which are counter to guidelines.Methods This qualitative study involved interviews with 28 care-home managers and health professionals involved in caring for patients with dementia. Potentially fallacious arguments were identified using qualitative content analysis and a coding framework constructed from existing explanatory models of fallacious reasoning.Key findings Fallacious arguments were identified in a range of explanations and reasons that participants gave for in answer to questions about initiating, reducing doses of and stopping antipsychotics in dementia. The dominant fallacy was false dichotomy. Appeal to popularity, tradition, consequence, emotion, or fear, and the slippery slope argument was also identified. Conclusions Fallacious arguments were often formulated to present convincing cases whereby prescribing antipsychotics or maintaining existing doses (versus not starting medication or reducing the dose, for example) appeared as the only acceptable decision but this is not always the case. The findings could help health professionals to recognise and mitigate the effect of logic-based errors in decisions about the prescribing of antipsychotics in dementia.
机译:背景技术痴呆可能导致难以管理的认知,非认知和行为症状。英国国家痴呆症的护理和管理正式准则,即抗透视症状的抗透视症状。这是因为在护理家庭环境中的不当使用,特别是有问题,可以产生严重的副作用,包括死亡。本研究的目的是探讨专业人士审议关于护理家庭环境中痴呆症患者抗精神病的审议中的荒谬论据。荒谬的论据有可能成为一个不起眼的秘密,构建和验证与指导方针的实践。方法,这种定性研究涉及与参与痴呆患者关心关心的28名护理家庭经理和健康专业人员的访谈。使用定性内容分析确定了潜在谬误的论据,以及由现有的解释模型构成的谬误,由谬误的理解模型构成。在一系列解释和参与者答案的解释和原因中,确定了对发起的问题,减少剂量和在痴呆症中停止抗精神病药。主要的谬论是假的二分法。对受欢迎程度,传统,后果,情感或恐惧呼吁,也发现了滑坡倾斜论点。结论常见的争论通常是制定令人信服的案件,从而规定抗精神病药或维持现有剂量(例如未开始用药或减少剂量)作为唯一可接受的决定,但情况并非总是如此。调查结果可以帮助卫生专业人员认识和减轻基于逻辑的误差在痴呆症抗精神病药方案的决定中的影响。

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