Klinikum rechts der Isar der Technischen Universität München: Klinik und Poliklinik für Psychiatrie und Psychotherapie, München, Germany.
kbo-Isar-Amper-Klinikum München-Ost, Klinik Nord, München, Germany.
Health Expect. 2021 Apr;24(2):507-515. doi: 10.1111/hex.13192. Epub 2021 Jan 15.
Shared decision making (SDM) in mental health may contribute to greater patient satisfaction and is sometimes associated with better health outcomes. Here, SDM should not only involve service users and clinicians but also involve the service users' caregivers.
This study aimed to achieve better insight into the current SDM patterns of triads of service users, caregivers and clinicians in inpatient mental health care and the three parties' expectations towards the prospects of triadic SDM.
The current research uses data from a representative cross-sectional study on caregivers in psychiatric inpatient treatment. We analysed data on n = 94 triads of service users, their caregivers and their clinicians.
All three parties acknowledge caregivers to be of great support to monitor the progress with mental disease. The caregiver's role during consultations is most often described as being an expert, receiving or providing information and supporting service users. However, caregivers at times try to seek support for themselves during caregiver-clinician interaction, or their behaviour was described as unhelpful. The potential prospects of caregiver involvement are clearly acknowledged despite the low implementation of caregiver involvement in this sample (only in one-third of the cases).
Triadic SDM rarely takes place in routine inpatient care. First, there should be a focus on interventions aiming at inviting caregivers to consultations. Only in the second step should a better conceptualisation of triadic SDM be undertaken.
Early results were discussed with a local peer support group for caregivers of individuals living with mental illness.
心理健康领域的共同决策（SDM）可能会提高患者满意度，有时还会带来更好的健康结果。在这里，SDM 不仅应涉及服务使用者和临床医生，还应涉及服务使用者的照顾者。
本研究旨在更深入地了解精神科住院患者中服务使用者、照顾者和临床医生三方的 SDM 模式，以及三方对三方 SDM 前景的期望。
本研究使用了一项针对精神科住院治疗中照顾者的代表性横断面研究的数据。我们分析了 n=94 例服务使用者、其照顾者和临床医生三方的配对数据。
三方都承认照顾者在监测精神疾病进展方面非常有帮助。在咨询过程中，照顾者的角色最常被描述为专家，负责接收或提供信息并支持服务使用者。然而，照顾者有时会在照顾者-临床医生互动中寻求自身支持，或者他们的行为被描述为无益。尽管在该样本中仅三分之一的情况下实施了照顾者参与，但照顾者参与的潜在前景得到了明确认可。
在常规住院护理中，三方 SDM 很少发生。首先，应重点关注邀请照顾者参与咨询的干预措施。只有在第二步，才应更深入地考虑三方 SDM 的概念化。
研究的初步结果与当地一个为照顾精神疾病患者的个人的同行支持小组进行了讨论。
