School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.
Nursing and Midwifery Research, School of Nursing and Midwifery, Monash University and Peninsula Health, Clayton, Victoria, Australia.
Int J Ment Health Nurs. 2020 Oct;29(5):846-855. doi: 10.1111/inm.12718. Epub 2020 Apr 6.
Shared decision-making is related to better health outcomes in serious mental illness. It is not well addressed in non-Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision-making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi-structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision-making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self-motivation in decision-making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses.
共同决策与严重精神疾病的更好健康结果有关。在非西方文化中，例如中国文化，共同决策并没有得到很好的解决。中国人在做出治疗决策时可能会受到家长制和家庭主义的影响。然而，这一点尚未得到探索。本研究的目的是从中国精神分裂症住院患者的角度探讨共同决策。本研究采用定性描述方法。通过半结构式访谈，来自一家三级医院精神科的 12 名参与者分享了他们对共同决策的看法。采用归纳主题分析方法对转录本进行分析。主要结果包括三个主题和九个子主题：(1) 积极的态度：i）希望自己的声音被听到，ii）需要家人的参与，和 iii）更倾向于让精神科医生决定；(2) 感到被排斥：i）经济能力有限，ii）缺乏互动沟通，iii）精神科医生太少，和 iv）对知情同意过程不满意；以及 (3) 通过：i）减轻家庭负担和 ii）积极收集健康信息来促进决策。在这种情况下，患者的治疗选择较少，在 SDM 中的作用有限。然而，他们对 SDM 有偏好，积极向心理健康专业人员，特别是护士寻求健康信息。
