Empowerment and satisfaction in a multinational study of routine clinical practice

Abstract

Mike (2015) Empowerment and satisfaction in a multinational study of routine clinical practice. Acta Psychiatrica Scandinavica, 131 (5). pp. 369-378. ISSN 1600-0447Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/34260/1/AFD%20APS%20CEDAR%20Empowerment %20and%20satisfaction.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. We tested whether mental health patients are more satisfied with a decision made (a) using their preferred decision-making style and (b) with a clinician with the same decision-making style preference. MethodAs part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. ResultsPatients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, p=0.005, 95%CI 1.32 to 4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, p=0.003, 95%CI 1.48 to 6.82). ConclusionMore active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction. KeywordsDecision Making, Mental Health 3. The extent to which the decision topic impacted on preference and agreement is unknown.4

Effects of Clinical Decision Topic on Patients’ Involvement in and Satisfaction With Decisions and Their Subsequent Implementation

“…A previous analysis of the CEDAR study data found that even more active involvement in decision-making than the patient stated as desired was associated 14 with higher satisfaction, indicating that a clinical orientation towards empowering may improve satisfaction for patients (27). Overall, the higher involvement and satisfaction for non-treatment decisions may reflect a complex causal pathway (28), in which both involvement and satisfaction are influenced by a range of factors such as clinical variables, and past history of contact with services.…”

Perceptions of shared decision‐making in severe mental illness: An integrative review

“…SDM is associated with a positive impact on health outcomes (e.g. treatment adherence, decision satisfaction, recovery and medical cost) (Clarke et al, ; Cosh et al, ; De las Cuevas & Peñate, ; De las Cuevas, Peñate, et al, ; Freidl et al, ; Klingaman et al, ; Younas et al, ), although causal relationships between SDM and outcomes cannot be established due to limited studies. MHPs’ preference for greater consumer involvement was associated with fewer unmet needs of consumers (Loos et al, ; Puschner et al, ).…”

Recovery and decision-making involvement in people with severe mental illness from six countries: a prospective observational study

“…Experience by the patient of active involvement is influenced by role expectations, treatment context, information, and clinician behavior. There is emerging evidence that more active decision-making (even than initially preferred by the patient) is associated with increased satisfaction and subsequent decision implementation [40] and poorer involvement and satisfaction in regard to treatment-related decisions, compared with social and financial decisions [41]. Furthermore, a preference by clinicians for active rather than shared or passive patient involvement in decision-making is associated with reductions in patient-rated unmet need 1 year later [42].…”