Measuring shared decision making processes in psychiatry: Skills versus patient satisfaction

Goossensen, Anne; Zijlstra, Paula; Koopmanschap, Marc

doi:10.1016/j.pec.2007.01.017

Cited by 102 publications

(112 citation statements)

References 16 publications

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“…For instance, some of the literature criticizes communication practices that do not support client-centered ideals (see Goossensen, Zijlstra & Koopmanschap, 2007), and yet models of health communication and evidence-based medicine (EBM) purport that one function of communication should be to promote behavior that will benefit disease management and treatment adherence (Tuckett, Boulton, Olson & Williams, 1985; cf. Pickering, 1993; see Barratt, 2008;Fulford, 2011 …”

Section: Role Of Epistemic Expertise In Managing Informationmentioning

confidence: 99%

Integrating Client and Clinician Perspectives on Psychotropic Medication Decisions: Developing a Communication-Centered Epistemic Model of Shared Decision Making for Mental Health Contexts

Mikesell

Bromley

Young

et al. 2015

Health Communication

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Shared decision making (SDM) interventions aim to improve client autonomy, information sharing and collaborative decision making, yet implementation of these interventions has been variably perceived. Using interviews and focus groups with clients and clinicians from mental health clinics, we explored experiences with and perceptions about decision support strategies aimed to promote SDM around psychotropic medication treatment. Using thematic analysis, we identified themes regarding beliefs about participant involvement, information management and participants' broader understanding of their epistemic expertise. Clients and clinicians highly valued clientcentered priorities such as autonomy and empowerment when making decisions.However, two frequently discussed themes revealed complex beliefs about what that involvement should look like in practice: 1) the role of communication and information exchange and 2) the value and stability of clinician and client epistemic expertise.Complex beliefs regarding these two themes suggested a dynamic and reflexive approach to information management. Situating these findings within the Theory of Motivated Information Management, we discuss implications for conceptualizing SDM in mental health services and adapt Siminoff and Step's Communication Model of Shared Decision Making (CMSDM) to propose a Communication-centered Epistemic Model of SharedDecision Making (CEM-SDM).3The quality of mental health care has been argued to be largely dependent on the quality of client-clinician communication (Priebe & McCabe, 2008), which is critical for accomplishing clinical tasks and improving health outcomes (Alegría et al., 2008;Wissow et al., 2008). The model of shared decision making (SDM) reconceptualizes client-clinician communication (Patel, Bakken & Ruland, 2008) by redefining the terms by which participants come together to make treatment decisions (Drake, Deegan & Rapp, 2010). In a SDM frame, neither clinicians (paternalistic model) nor clients (informed choice model) are singularly responsible for making decisions (Makoul & Clayman, 2006). Instead, decision making is characterized by the exchange of unbiased information (Drake et al., 2010), collaboration (Charles, Gafni & Whelan, 1999) and mutual respect for differing expertise (Deegan & Drake, 2006). Given the centrality of communication in mental health care, we believe the assumptions underlying SDM warrant critical examination.For instance, despite widespread support for SDM, its principles are not uniformly perceived or advocated. Not all clients desire high levels of autonomy (Levinson, Kao, Kuby & Thisted, 2005; Say, Murtagh & Thompson, 2006), and psychiatrists have been found to both value and criticize elements of SDM including the exchange of unbiased information (Seale, Chaplin, Lelliott & Quirk, 2006). To elucidate these discrepancies, we elicited perspectives from clients and mental health clinicians about their experiences making and facilitating medication decisions and about strategies that might suppo...

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Section: Role Of Epistemic Expertise In Managing Informationmentioning

confidence: 99%

Integrating Client and Clinician Perspectives on Psychotropic Medication Decisions: Developing a Communication-Centered Epistemic Model of Shared Decision Making for Mental Health Contexts

Mikesell

Bromley

Young

et al. 2015

Health Communication

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“…Previous research has shown that clinicians are concerned about mental health patients participating in some decisions (8), and that patients CDM preferences are not often sought (38).…”

Section: Sdm Is Not Yet Routine (34)mentioning

confidence: 99%

Empowerment and satisfaction in a multinational study of routine clinical practice

Clarke

Puschner

Jordan

et al. 2014

Acta Psychiatr Scand

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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

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“…SDM involves collaborative partnership between patients and providers who are both considered experts and are expected to participate in deliberation about treatment decisions (Charles, Gafni, & Whelan, 1997). Studies in various clinical settings have found that patients prefer SDM (Adams, Drake, & Wolford, 2007;Betinger, Kissling, & Hamann, 2014;Goossensen, Ziilstra & Koopmanschap, 2007;Hamann, Cohen, Leucht, Busch, & Kissling, 2005;Hill & Laugharne, 2005;Matthias, Salyers, Rollins, & Frankel, 2012a).…”

mentioning

confidence: 99%

Factors influencing patients’ preferences and perceived involvement in shared decision-making in mental health care

Eliacin

Salyers

Kukla

et al. 2014

Journal of Mental Health

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Measuring shared decision making processes in psychiatry: Skills versus patient satisfaction

Cited by 102 publications

References 16 publications

Integrating Client and Clinician Perspectives on Psychotropic Medication Decisions: Developing a Communication-Centered Epistemic Model of Shared Decision Making for Mental Health Contexts

Integrating Client and Clinician Perspectives on Psychotropic Medication Decisions: Developing a Communication-Centered Epistemic Model of Shared Decision Making for Mental Health Contexts

Empowerment and satisfaction in a multinational study of routine clinical practice

Factors influencing patients’ preferences and perceived involvement in shared decision-making in mental health care

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