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Gurtner, C; Lohrmann, C; Schols, JMGA; Hahn, S.
Shared Decision Making in the Psychiatric Inpatient Setting: An Ethnographic Study about Interprofessional Psychiatric Consultations.
Int J Environ Res Public Health. 2022; 19(6): Doi: 10.3390/ijerph19063644 [OPEN ACCESS]
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Lohrmann Christa
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Abstract:
Shared decision making is increasingly receiving attention in health care and might improve both the quality of care and patient outcomes. Nevertheless, due to its complexity, implementation of shared decision making in clinical practice seems challenging. This ethnographic study aimed to gain a better understanding of how psychiatric inpatients and the interprofessional care team interact during regular interprofessional psychiatric consultations. Data were collected through participant observation on two different psychiatric wards in a large psychiatric hospital in Switzerland. The observation focused on the contextual aspects of interprofessional patient consultations, the communication and interaction as well as the extent to which patients were involved in decision making. Participants included patients, psychiatrists, junior physicians, nurses, psychologists, social workers and therapists. We observed 71 interprofessional psychiatric consultations and they differed substantially in both wards in terms of context (place and form) and culture (way of interacting). On the contrary, results showed that the level of patient involvement in decision making was comparable and depended on individual factors, such as the health care professionals' communication style as well as the patients' personal initiative to be engaged. The main topics discussed with the patients related to pharmacotherapy and patient reported symptoms. Health care professionals in both wards used a rather unidirectional communication style. Therefore, in order to promote patient involvement in the psychiatric inpatient setting, rather than to focus on contextual factors, consultations should follow a specific agenda and promoting a bidirectional communication style for all parties involved is strongly recommended.
Find related publications in this database (using NLM MeSH Indexing)
Decision Making - administration & dosage
Decision Making, Shared - administration & dosage
Humans - administration & dosage
Inpatients - administration & dosage
Patient Participation - administration & dosage
Referral and Consultation - administration & dosage

Find related publications in this database (Keywords)
shared decision making
clinical practice
psychiatric inpatient setting
interprofessional psychiatric consultations
psychiatric disorder
mental illness
communication
patient involvement
patient-centered care
participant observation
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