Department of Social and Behavioral Science, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Veterans Affairs Medical Center, and Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Lysaker); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon).
Psychiatr Serv. 2021 Apr 1;72(4):461-463. doi: 10.1176/appi.ps.202000156. Epub 2021 Feb 9.
Shared decision making (SDM) is an interpersonal health communication model that is underutilized with people with serious mental illness. Although research has emphasized the role of patient capacity-, clinician-, and system-related barriers in SDM underutilization, the risk taking that affects SDM with people with mental illness is less often discussed. This Open Forum presents a reconceptualization of SDM as a process of shared risk taking that often occurs during different phases of illness management and recovery. The concepts of intersubjectivity, meaning making, and metacognition are offered to inform clinical interventions needed to address risk in SDM.
共享决策(SDM)是一种人际健康沟通模式,在严重精神疾病患者中未得到充分利用。尽管研究强调了患者能力、临床医生和系统相关障碍在 SDM 利用不足中的作用,但影响精神疾病患者 SDM 的风险决策却较少被讨论。本论坛提出将 SDM 重新概念化为一种共享风险决策的过程,这种过程通常发生在疾病管理和康复的不同阶段。主体间性、意义构建和元认知的概念被提出来为解决 SDM 中的风险所需的临床干预提供信息。