Drivers of shared decision making in inpatient psychiatry: An exploratory survey of patients' and multi-disciplinary team members' perspectives

Erick H. Cheung, Emily Petersen, Lily Zhang, Catherine Wilkerson, Nicolás E. Barceló, Patricia D. Soderlund, Maria Yerstein, Kenneth Wells

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the prevalence and predictors of Shared Decision Making (SDM) in an adult, inpatient psychiatric setting. Method: Multi-disciplinary clinician focus groups and patient pre-testing informed the development of a survey on 4 SDM and 11 factors hypothesized to interfere with SDM. The survey was administered to 89 adult inpatients (80% response rate) and their treatment team psychiatrists, nurses, and social workers (n = 338 ratings, 95% response rate). Group differences and predictors were estimated using t and F-tests. Results: Patients' mean SDM score (n = 64, standardized Cronbach alpha = 0.858) was 3.35 ± 1.13 (5 = highest agreement), and correlated with overall satisfaction with care (n = 61, r = 0.399, p = 0.001). Patients' disagreement with clinician's diagnosis (44% of patients) correlated with lower SDM ratings by patients (t = 2.55, df = 62, p = 0.013) and by clinicians (t = 2.99, df = 69, p = 0.004). Psychotic diagnoses were not a significant determining factor for SDM. Overall, clinicians rated SDM more favorably than patients (t = −5.43, df = 63, p < 0.001), with nurses and social workers rating SDM higher than physicians (p < 0.001). Conclusions: Diagnostic agreement / disagreement is a key predictor of SDM for patients and clinicians, while presence of psychosis is not. SDM was rated higher by clinicians than patients. SDM ratings vary significantly between clinical disciplines.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalGeneral Hospital Psychiatry
Volume79
DOIs
StatePublished - Nov 1 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors

Keywords

  • Decisional capacity
  • Diagnostic agreement
  • Inpatient psychiatry
  • Patient Satisfaction
  • Quality improvement
  • Shared decision making

PubMed: MeSH publication types

  • Journal Article

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