Faculty of Medicine, University of La Laguna, Campus de Ofra s/n, San Cristóbal de La Laguna, Canary Islands 38071, Spain.
BMC Psychiatry. 2012 May 30;12:53. doi: 10.1186/1471-244X-12-53.
Concordance and Shared Decision-Making (SDM) are considered measures of the quality of care that improves communication, promotes patient participation, creates a positive relationship with the healthcare professional, and results in greater adherence with the treatment plan.
This study compares the attitudes of 225 mental health professionals (125 psychiatrists and 100 psychiatry registrars) and 449 psychiatric outpatients towards SDM and concordance in medicine taking by using the "Leeds Attitude toward Concordance Scale" (LATCon).
The internal consistency of the scale was good in all three samples (Cronbach's α: patients = 0.82, psychiatrists = 0.76, and registrars = 0.82). Patients scored significantly lower (1.96 ± 0.48) than professionals (P < .001 in both cases), while no statistically significant differences between psychiatrists (2.32 ± 0.32) and registrars (2.23 ± 0.35) were registered; the three groups showed a positive attitude towards concordance in most indicators. Patients are clearly in favor of being informed and that their views and preferences be taken into account during the decision-making process, although they widely consider that the final decision must be the doctor's responsibility. Among mental health professionals, the broader experience provides a greater conviction of the importance of the patient's decision about treatment.
We observed a positive attitude towards concordance in the field of psychotropic drugs prescription both in professionals and among patients, but further studies are needed to address the extent to which this apparently accepted model is reflected in the daily practice of mental health professionals.
一致性和共同决策（SDM）被认为是改善沟通、促进患者参与、与医疗保健专业人员建立积极关系以及提高治疗计划依从性的医疗质量的衡量标准。
本研究使用“利兹一致性态度量表”（LATCon）比较了 225 名心理健康专业人员（125 名精神科医生和 100 名精神科住院医师）和 449 名精神科门诊患者对 SDM 和药物治疗一致性的态度。
在所有三个样本中，量表的内部一致性都很好（患者：Cronbach's α = 0.82，精神科医生：0.76，住院医师：0.82）。患者的得分明显低于专业人员（均为 P <.001），而精神科医生（2.32 ± 0.32）和住院医师（2.23 ± 0.35）之间没有统计学上的显著差异；三组在大多数指标上对一致性持积极态度。患者显然赞成被告知，并希望在决策过程中考虑到他们的观点和偏好，尽管他们普遍认为最终决定必须由医生负责。在心理健康专业人员中，更广泛的经验使他们更加坚信患者对治疗决策的重要性。
我们观察到在精神药物处方领域，专业人员和患者都对一致性持积极态度，但需要进一步研究以了解这种显然被接受的模式在精神卫生专业人员的日常实践中得到了多大程度的反映。
