Patients’ perspectives on shared decision making in secondary mental healthcare in Taiwan: A qualitative study

Lin, Chiu-Yi; Renwick, Laoise; Lovell, Karina

doi:10.1016/j.pec.2020.05.030

Cited by 15 publications

(25 citation statements)

References 42 publications

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“…Only one quantitative study measuring recovery, 16 a primary goal and outcome in mental health that is associated with SDM, [19][20][21] was included. Of the included qualitative studies, [22][23][24][25][26][27][28][29][30][31] only four [24][25][26]28 involved the perspectives and attitudes of patients or individuals with mental health conditions on SDM (the rest addressed providers' perspectives [22][23][24][25][27][28][29][30][31] ), and most of these qualitative studies were valued by the NICE as having a high 22,27,28 to moderate 23,24,26 risk of bias. SDM research in mental health has evolved rapidly in the past two decades, 3 presenting one of the fastest growth curves in SDM research and practice.…”

Section: Bias In the Selection Of Qualified Evidence For What Is Considered Sdm In Mental Healthmentioning

confidence: 99%

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

et al. 2021

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Section: Bias In the Selection Of Qualified Evidence For What Is Considered Sdm In Mental Healthmentioning

confidence: 99%

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

et al. 2021

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“…It may be that health professionals are reluctant to give up their power, as one study in this review (Davies and Gray, 2015) found that service users, in general, were cynical as to whether there was genuine wiliness, of the medical health professionals, to hand over decision-making power to service users. On the other hand, although a Taiwanese-based study in this review revealed that although patients wanted more involvement in decision-making, they were hindered by their own cultural expectations of the relationship dynamic between doctors and themselves (Lin et al, 2019). Hence, more cross-cultural studies are needed on shared decision-making within mental health care.…”

Section: Discussionmentioning

confidence: 85%

“…On the other hand, shared decision-making could be cultural driven. In one Taiwanese-based study, patients were reluctant to be involved in decision-making because they viewed health professionals as authority figures whom they felt they should obey (Lin et al, 2019).…”

Section: Shared Decision-makingmentioning

confidence: 99%

Mental health service users’ lived experiences of recovery-oriented services: a scoping review

Lau

Hutchinson

2021

MHRJ

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Purpose Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision. Design/methodology/approach This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings. Findings Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3. Research limitations/implications This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts. Practical implications On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity. Social implications Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care. Originality/value This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.

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“…42 Physicians who are open, calm and empathetic make patients feel more comfortable, and this may enable patients to feel respected and they may be honest in sharing views. 43,44 Physicians with a positive attitude to SDM, and less work pressure are more likely to implement SDM. 28,45,46 3.4.3 | Structure level-Theme 3: Resource supply Significant gains in information by using Decision Aids can promote decision engagement and improve treatment adherence compared to routine care, 47 while limited available resources, such as information resources, financial resources and human resources, are seen as critical factors in bridging the divide between the practical and ideal performance of SDM.…”

Section: Factors Of Motivation For and Resistance To Implementing Sdmmentioning

confidence: 99%

Exploring motivations and resistances for implementing shared decision‐making in clinical practice: A systematic review based on a structure–process–outcome model

Tang

Wang

2022

Health Expectations

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Objective: Shared decision-making (SDM) as a multicollaborative approach is vital for facilitating patient-centred care. Considering the limited clinical practice, we attempted to synthesize the motivations and resistances, and investigate their mutual relationships for advancing the implementation of SDM.Methods: A comprehensive systematic review using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines was performed. 'Shared decision making' was searched as the mesh term through PubMed, Web of Science and EBSCO from 2000 to 2021, and the quality of literature was appraised using the QualSyst Tool. Motivations and resistances were categorized based on content analysis and the 'structure-process-outcome' model.Results: From 8319 potential citations, 105 were included, comprising 53 qualitative studies (the average quality score is 0.92) and 52 quantitative studies (the average quality score is 0.95). A total of 42 categories of factors were identified into 11 themes and further grouped into three dimensions: structure, process and outcome.The structure dimension comprised six themes (71.43%), the process dimension contained four themes (11.01%) and the outcome dimension covered only one theme. Across all categories, decision-making time and patients' decision preparedness in the process dimension were the most reported, followed by physicians' communication skills and health care environment in the structure dimension.Analysis of implementation of SDM among various types of diseases showed that more influencing factors were extracted from chronic diseases and unspecified disease decisions. Conclusions:The major determinants for the implementation of SDM are focused on the structural dimension, which challenges the health systems of both developed and low-and middle-income countries. Furthermore, we consider it important to

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Patients’ perspectives on shared decision making in secondary mental healthcare in Taiwan: A qualitative study

Cited by 15 publications

References 42 publications

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

Mental health service users’ lived experiences of recovery-oriented services: a scoping review

Exploring motivations and resistances for implementing shared decision‐making in clinical practice: A systematic review based on a structure–process–outcome model

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