Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.
kbo-Isar-Amper-Klinikum München, Munich, Germany.
Health Expect. 2023 Jun;26(3):1327-1338. doi: 10.1111/hex.13749. Epub 2023 Mar 14.
Decision aids (DAs) are promising tools to foster evidence-based shared decision-making between practitioners and service users. Nevertheless, it is still obscure how an evidence-based DA for people with severe mental illness, especially psychosis, should look in an inpatient treatment setting to be useful and feasible. Therefore, we conducted focus groups with psychiatrists and service users to collect and assess their expectations and wishes regarding an evidence-based DA. From these findings, we derived immediate recommendations for the future development of DAs.
We held two group interviews with service users (n = 8) and three group interviews with psychiatrists (n = 10). We used an open, large-scale topic guide. First, we presented data from a current meta-analysis on antipsychotics to the interviewees and, in a second step, asked for their expectations and wishes towards a DA that integrates these data.
Our thematic analysis revealed six key themes addressed by the respondents: (1) general considerations on the importance and usefulness of such a DA, (2) critical comments on psychiatry and psychopharmacotherapy, (3) communicative prerequisites for the use of a DA, (4) form and content of the DA, (5) data input, data processing and output as well as (6) application of the DA and possible obstacles.
Participants identified several important features for the development of DAs for selecting antipsychotics in inpatient psychiatric treatment. The digital format was met with the greatest approval. Especially the adaptability to different needs, users and psychopathologies and the possibility to outsource information dissemination via app seemed to be a decisive convincing argument. Further research is required to test specific features of DAs to be developed in clinical settings.
决策辅助工具（DAs）是促进从业者和服务使用者之间基于证据的共享决策的有前途的工具。然而，对于严重精神疾病患者，特别是精神病患者，在住院治疗环境中，基于证据的 DA 应该是什么样子才能具有实用性和可行性，目前仍不清楚。因此，我们与精神科医生和服务使用者进行了焦点小组讨论，以收集和评估他们对基于证据的 DA 的期望和愿望。从这些发现中，我们得出了对未来 DA 发展的直接建议。
我们与 8 名服务使用者进行了两次小组访谈，与 10 名精神科医生进行了三次小组访谈。我们使用了一个开放的、大规模的主题指南。首先，我们向受访者展示了一项关于抗精神病药的当前荟萃分析数据，然后在第二步中，询问他们对整合这些数据的 DA 的期望和愿望。
我们的主题分析揭示了受访者提出的六个关键主题：（1）对这样的 DA 的重要性和实用性的一般考虑，（2）对精神病学和精神药理学的批评意见，（3）使用 DA 的交流前提条件，（4）DA 的形式和内容，（5）数据输入、数据处理和输出以及（6）DA 的应用和可能的障碍。
参与者确定了开发用于选择住院精神病治疗中抗精神病药的 DA 的几个重要特征。数字格式最受欢迎。特别是对不同需求、用户和精神病理学的适应性以及通过应用程序外包信息传播的可能性似乎是一个决定性的令人信服的论据。需要进一步研究来测试在临床环境中开发的特定 DA 特征。
