GGz Breburg, Postbus 770, 5000, AT, Tilburg, The Netherlands.
Trimbos Institute, Postbus 725, 3500, AS, Utrecht, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2018 Feb;53(2):161-169. doi: 10.1007/s00127-017-1467-9. Epub 2017 Dec 6.
Decisional conflict refers to the degree to which patients are engaged in and feel comfortable about important clinical decisions. Until now, the concept has received little attention in mental health care. We investigate the level of decisional conflict in mental health care and whether this is influenced by socio-demographics, treatment setting, diagnoses, and locus of control.
Cross-sectional study among 186 patients in Dutch specialist mental health care using the Decisional Conflict Scale, which measures five dimensions of decisional conflict: information, support, clarification of values, certainty, and decisional quality. Descriptive statistics and forward stepwise linear regression analyses were used.
Patients report relatively high levels of decisional conflict, especially those with more external locus of control. Having a personality disorder and higher education also increases decisional conflict on the dimensions support and clarification of values, respectively. Less decisional conflict was experienced by patients with psychotic disorders on the dimension certainty and by women on the information domain.
Decisional conflict is common among patients in specialist mental health care and is very useful for assessing the quality of clinical decision making. Measuring decisional conflict and knowledge about influencing factors can be used to improve patients' participation in clinical decision making, adherence to treatment and clinical outcomes.
决策冲突是指患者对重要临床决策的参与程度和舒适度。到目前为止，这一概念在精神卫生保健中还没有得到太多关注。我们调查了精神卫生保健中的决策冲突水平，以及它是否受到社会人口统计学、治疗环境、诊断和控制源的影响。
在荷兰精神卫生专家护理中心的 186 名患者中进行横断面研究，使用决策冲突量表（Decisional Conflict Scale）测量决策冲突的五个维度：信息、支持、价值观澄清、确定性和决策质量。采用描述性统计和逐步线性回归分析。
患者报告的决策冲突程度相对较高，特别是那些具有外部控制源的患者。具有人格障碍和较高教育程度的患者在支持和价值观澄清维度上的决策冲突程度也较高。精神障碍患者在确定性维度上的决策冲突程度较低，女性在信息领域的决策冲突程度也较低。
决策冲突在精神卫生专家护理中的患者中很常见，对于评估临床决策的质量非常有用。测量决策冲突以及影响因素的知识可用于改善患者对临床决策的参与、治疗依从性和临床结果。
