Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.
The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.
The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.
The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.
Notes
Cites: Aust N Z J Psychiatry. 2002 Dec;36(6):717-32 PMID 12406114
Cites: Worldviews Evid Based Nurs. 2016 Feb;13(1):25-31 PMID 26788694
Cites: Health Expect. 2016 Oct;19(5):1002-14 PMID 26260361
Cites: J Ment Health. 2013 Dec;22(6):563-9 PMID 24205790
Cites: Psychiatr Rehabil J. 2015 Dec;38(4):328-35 PMID 26053531