"It Becomes, Uh, Muddy." Navigating Treatment Complexities and Uncertainties: Medical Doctors' Discourses on Patients with Dual Diagnosis.

Treatment of dual diagnosis patients is multifaceted and requires, among other things, a strong professional approach to complex medical conditions and a strong professional attitude, uninfluenced by prejudice and moral judgment. However, studies have shown that these patients remain a challenge for many health professionals in the sense that they seem to elude sufficient treatment. In this study we have examined the possible contributions from the staff attitude by analyzing discourse. Methods: qualitative interviews and observation of iterations and descriptions of dual diagnosis patients in medical doctors of differentiated experience in psychiatry and dual diagnosis were used as data collection methods. Discourse theory was used to analyze and depict attitudes and discourses surrounding the patient group. Result: three main discourses were identified in the material, as well as the influence of private opinions and blind spots. The three discourses are "professional uncertainty," "flipped power balance" and "clinical compassion." Conclusion: medical doctors are not solely professional in their assessment of dual diagnosis but influenced by surrounding discourses in society and clinical contexts, meanwhile contributing to the maintenance of discourses related to this group of patients.