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What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Patient involvement in decision making is endorsed by patients and professionals. While research has recently been conducted on how professionals can promote shared decision making (SDM), little is known about how patients can also facilitate SDM.

Methods

Seven focus groups were conducted: 3 with psychiatrists and 4 with patients with schizophrenia or depression. The focus groups were transcribed and independently coded line by line by 2 researchers. Data were analyzed using content analysis.

Results

Seven themes related to patient attitudes and behaviors were identified: honesty and openness with one’s psychiatrist and oneself, trust in one’s psychiatrist and patience with the treatment, respect and politeness, informing the psychiatrist and giving feedback, engagement/active participation during the consultation, gathering information/preparing for the consultation and implementing decisions. Barriers (e.g., avolition, lack of decisional capacity, powerlessness during involuntary treatment) and facilitators of active patient behavior were also identified.

Conclusions

There are various ways in which patients can facilitate SDM/play a more active role in decision making, with patients emphasizing being open and honest and psychiatrists emphasizing being active in the consultation. Interventions to increase active patient behavior may enhance SDM in mental health care.

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Acknowledgments

This study was funded by the German Ministry for Research and Education (Grant Number 01GX1049). The authors would like to thank Prof. Rudolf Cohen for his advice and help.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Psychiatric Department, Technische Universität München, Munich, Germany

    Johannes Hamann, S. Kohl & R. Mendel

  2. University of Exeter Medical School, Exeter, UK

    R. McCabe

  3. Department for Psychology, Ludwig-Maximilian-Universität München, Munich, Germany

    M. Bühner

  4. Isar Amper Klinikum München Ost, kbo, Haar, Germany

    M. Albus & J. Bernd

Authors
  1. Johannes Hamann
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  2. S. Kohl
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  3. R. McCabe
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  4. M. Bühner
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  5. R. Mendel
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  6. M. Albus
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  7. J. Bernd
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Corresponding author

Correspondence to Johannes Hamann.

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Hamann, J., Kohl, S., McCabe, R. et al. What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists. Soc Psychiatry Psychiatr Epidemiol 51, 617–625 (2016). https://doi.org/10.1007/s00127-015-1089-z

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  • DOI: https://doi.org/10.1007/s00127-015-1089-z

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