Verwijmeren Doris, Grootens Koen P
Reinier van Arkel Mental Health Institute, Postbus 70058, 5201 DZ, 's-Hertogenbosch, The Netherlands.
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
Int J Bipolar Disord. 2018 Oct 4;6(1):21. doi: 10.1186/s40345-018-0129-5.
Shared decision making has been promoted as standard care, but there has been debate on the possible types. On the one hand, there is a more 'instrumental'/objective approach focused on the exchange of information, but an 'interpersonal'/subjective patient involvement has been suggested as well. In this study we aim to investigate this further by assessing both actual and perceived patient involvement in medical decisions.
Eighty-one consultations between patients with bipolar disorder and their clinicians were observed and scored using the OPTION scale. Afterwards, the patients' experienced involvement was explored with the SDM-Q-9. Furthermore, several patient characteristics were gathered. Correlations between the scores were examined.
The clinicians scored on average 34.6 points on the OPTION scale. In contrast, patients scored on average 77.5 points on the SDM-Q-9, suggesting that patients felt more involved in the consultation than was observable.
Our patients with bipolar disorder feel involved in pharmacotherapy decisions, but this is not scored in objective observations. Our data suggest that there are implicit, interpersonal aspects of patient involvement in shared decision making, a concept that deserves further attention and conceptualisation.
共同决策已被推广为标准治疗方式，但对于其可能的类型存在争议。一方面，存在一种更“工具性”/客观性的方法，侧重于信息交流，但也有人提出了“人际性”/主观性的患者参与方式。在本研究中，我们旨在通过评估患者在医疗决策中的实际参与度和感知参与度来进一步探究这一问题。
观察了81例双相情感障碍患者与其临床医生之间的会诊，并使用OPTION量表进行评分。之后，使用SDM-Q-9探究患者的参与体验。此外，收集了若干患者特征。检查了评分之间的相关性。
临床医生在OPTION量表上的平均得分为34.6分。相比之下，患者在SDM-Q-9上的平均得分为77.5分，这表明患者感觉自己在会诊中的参与度高于观察到的情况。
我们的双相情感障碍患者感觉自己参与了药物治疗决策，但在客观观察中并未体现这一点。我们的数据表明，患者参与共同决策存在隐性的人际方面，这一概念值得进一步关注和概念化。
