Department of Psychiatry, University of La Laguna, Tenerife, Spain ; Health Services Research Network for Chronic Diseases (REDISSEC), Tenerife, Spain.
Neuropsychiatr Dis Treat. 2013;9:1045-52. doi: 10.2147/NDT.S49021. Epub 2013 Jul 30.
To measure and compare the extent to which shared a decision making (SDM) process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient's perspective.
A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9) immediately after their consultation. MANCOVA, Student's t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples.
No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients' age, education, type of appointment, and treatment decision all play a specific role in predicting SDM.
The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.
从患者角度出发，衡量和比较精神科门诊临床和初级保健环境中共享决策（SDM）过程实施的程度。
从加那利群岛卫生服务精神卫生和初级保健部门招募了总共 1477 名患者，邀请他们在咨询后立即完成九项共享决策问卷调查（SDM-Q-9）。MANCOVA、学生 t 检验和 Pearson 相关性用于评估患者样本中 SDM-Q-9 评分之间的关系和差异。
两个患者样本的 SDM-Q-9 总分没有差异，但逐项分析时存在相关差异；根据 SDM 过程的不同步骤观察到差异。与初级保健相比，SDM 在常规精神科环境中的应用非常有限。患者的年龄、教育程度、预约类型和治疗决策都在预测 SDM 方面发挥了特定作用。
该研究提供了证据表明，SDM 是一个复杂的过程，需要根据其不同步骤进行分析。初级保健和精神科门诊护理环境中的 SDM 模式不同，反映了决策过程的截然不同的观点。
