Perceptions of shared decision-making in severe mental illness : an integrative review
- Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Psychiatric and Mental Health Nursing Vol. 27, no. 2 (Apr 2020), p. 103-127
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- Description: Accessible SummaryWhat is known about shared decision-making? There is increasing evidence of the positive impact of shared decision-making on health outcomes. There has been little exploration of shared decision-making regarding people diagnosed with serious mental illness from the perspectives of key stakeholders including consumers, families and mental health professionals. What this paper adds to existing knowledge? Consumers show variability in the preference for their involvement. Most stakeholders acknowledge the importance of family involvement. MHPs should share the responsibility and right to facilitate consumer involvement. There is bidirectional association between shared decision-making and therapeutic relationships. The practice of shared decision-making is related to multiple factors, and one main perceived barrier is time. The majority of studies are from Western countries. What are the implications for practice? Elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making. Inter-professional collaboration should be integrated into shared decision-making. It might require lengthier consultation time. Studies in non-Western countries are needed to fully understand the impact of culture on shared decision-making. Shared decision-making (SDM) has been broadly advocated in health services and constitutes an important component of patient-centred care and relationship-based care. To review available literature related to perceptions of key stakeholders about shared decision-making in serious mental illness. An integrative review was conducted through a search of four online databases from January 2012 to June 2019. Forty-six articles were included. Six themes were generated from the data analysis: (a) dynamic preferences for SDM, (b) various stakeholders are rarely involved, (c) SDM is not routinely implemented, (d) multiple facilitators and barriers to SDM, (e) SDM and therapeutic relationships interact, (f) SDM has a promising impact on health outcomes. Overall, most stakeholders have recognized the importance and flexibility of SDM in serious mental illness, although it is not routine in mental health service. Consumer preferences show variability in their involvement. Most stakeholders acknowledged the importance of family involvement to treatment decision-making. There are several significant challenges to practice SDM. It may require extended consultation times and increasing empirical evidence regarding the SDM outcomes, as well as integrating inter-professional collaboration into SDM. Most studies were conducted in Western culture. Mental health nurses should elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making when consumers prefer their families to be involved. Inter-professional collaboration should be integrated into shared decision-making. The practice of shared decision-making might need extended consultation time and more robust evidence about the outcome of shared decision-making. Studies in non-Western cultures are needed to fully understand cultural issues of shared decision-making. IntroductionAimMethodResultsDiscussionImplications for practice
Shared decision-making in serious mental illness : a comparative study
- Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Patient Education and Counseling Vol. 103, no. 8 (2020), p. 1637-1644
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- Description: Objective: To compare consumer and mental health professionals’ (MHPs) preferences for decision-making in China and Europe. Methods: This study used cross-sectional design; Chinese data were collected by questionnaires and European data were obtained from the literature. Data were analysed using t-test, One-way ANOVA and Pearson correlation coefficient as appropriate. Results: This study involved 800 people diagnosed with severe mental illness and 506 MHPs. Chinese participants rated lower scores on preference for participation in decision-making (PD = 1.88) and information (IN = 2.70) than European participants (PD = 2.05, IN = 2.83). Chinese consumers rated a higher score on IN (2.78) but lower on for PD (1.75) than MHPs (IN = 2.64, PD = 1.97). Chinese consumers’ education level is positively associated with preference for PD and IN. The gender, occupation and age of Chinese MHPs are associated with preference for PD. Conclusion: Both Chinese and Europeans had preference for shared involvement in mental health, while the preference in China is less. Opinions of consumers and MHPs might be different, regarding the level of patient involvement in specific decisions. Practice implication: It is essential that consumers’ preferences are understood for provision of optimal support for a shared decision-making approach. © 2020 Elsevier B.V.
Translation and psychometric testing of a decision-making scale
- Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Psychiatric and Mental Health Nursing Vol. 27, no. 5 (2020), p. 533-542
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- Description: What is known about shared decision-making?: There is increasing investigation of shared decision-making in mental health services. Exploration of shared decision-making and relevant instrument is scant in China. What this paper adds to existing knowledge?: In this study, the Clinical Decision-making Involvement and Satisfaction (CDIS) was translated into Chinese and validated with patients and mental health professionals. The Chinese version of the CDIS is a reliable and valid instrument for measuring perception of involvement and satisfaction with treatment decision for schizophrenia. What are the implications for practice?: Mental health nurses could use the CDIS patient-rated and health professional-rated versions to compare their perceptions of the decision-making process. Abstract: Introduction There is growing interest in shared decision-making in Chinese mental health services. However, few specific instruments are available to measure decision-making satisfaction and involvement. Aim To translate and validate Clinical Decision-making Involvement and Satisfaction (CDIS) in a Chinese population. Methods The translation process was completed based on the Brislin translation method. Convenience sampling of 505 participants including 212 people diagnosed with schizophrenia and 293 mental health professionals for psychometric testing (e.g., content and construct validity, and test-retest reliability). Results The CDIS Chinese version has good internal consistency and temporal stability. Factor analysis determined two factors including satisfaction and involvement subscales, explaining 60.08% of the total variance. The Cronbach's α was 0.70, and the intraclass correlation coefficient ranged from 0.83 to 0.89. The composite reliability value was 0.85, and the average variance extracted was 0.50. Critical Ratio values ranged from 5.28 to 17.95, and item-total correlation values ranged from 0.48 to 0.75. Discussion The CDIS Chinese version is a feasible and reliable instrument. © 2020 John Wiley & Sons Ltd
- Description: Chongmei Huang is supported by a China Scholarship Council (Res: [2017] 3109).
An evaluation of a positive psychological intervention to reduce burnout among nurses
- Authors: Luo, Yuan-Hui , Li, Hui , Plummer, Virginia , Cross, Wendy , Lam, Louisa , Guo, Yu-Fang , Yin, Yi-Zhen , Zhang, Jing-Ping
- Date: 2019
- Type: Text , Journal article
- Relation: Archives of Psychiatric Nursing Vol. 33, no. 6 (Dec 2019), p. 186-191
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- Description: This quasi-experimental study aimed to evaluate the positive psychological intervention of recording three good things on alleviating nurses' burnout. Eighty-seven nurses with burnout were recruited. Nurses in the study group recorded three good things using communication tool WeChat for six months, no records were made in the control group. After intervention, the score of exhaustion decreased considerably for nurses in the study group. Nurses recording three good things on average twice a week returned the lowest score of exhaustion. This intervention combined with appropriate surveillance and encouragement is recommended to reduce nurses' burnout and create a positive work environment.