Federation University Australia, Institute of Health and Wellbeing, Berwick, Victoria, Australia.
College of Sports, Health and Engineering, Victoria University, Melbourne, Victoria, Australia.
Issues Ment Health Nurs. 2024 Mar;45(3):294-310. doi: 10.1080/01612840.2023.2288181. Epub 2024 Jan 17.
Person-centred decision-making approaches in mental health care are crucial to safeguard the autonomy of the person. The use of these approaches, however, has not been fully explored beyond the clinical and policy aspects of shared and supported decision-making. The main goal is to identify and collate studies that have made an essential contribution to the understanding of shared, supported, and other decision-making approaches related to adult mental health care, and how person-centred decision-making approaches could be applied in clinical practice. A scoping review of peer-reviewed primary research was undertaken. A preliminary search and a main search were undertaken. For the main search, eight databases were explored in two rounds, between October and November 2022, and in September 2023, limited to primary research in English, Spanish or Portuguese published from October 2012 to August 2023. From a total of 12,285 studies retrieved, 21 studies were included. These research articles, which had mixed quality ratings, focused on therapeutic relationships and communication in decision-making (30%), patients' involvement in treatment decision-making (40%), and interventions for improving patients' decision-making engagement (30%). While there is promising evidence for shared decision-making in mental health care, it is important that healthcare providers use their communicational skills to enhance the therapeutic relationship and engage patients in the process. More high-quality research on supported decision-making strategies and their implementation in mental health services is also required.
以人为本的决策方法在精神卫生保健中至关重要，可以保障患者的自主权。然而，除了共同决策和支持决策的临床和政策方面，这些方法的应用尚未得到充分探索。主要目标是确定和整理那些对理解共同决策、支持决策和成人精神卫生保健相关的其他决策方法做出重要贡献的研究，并探讨以人为本的决策方法如何在临床实践中应用。本研究采用了范围综述方法，对同行评审的原始研究进行了综述。进行了初步检索和主要检索。主要检索于 2022 年 10 月至 11 月和 2023 年 9 月分两轮在八个数据库中进行，仅限于 2012 年 10 月至 2023 年 8 月期间以英文、西班牙语或葡萄牙语发表的原始研究。在总共检索到的 12285 项研究中，纳入了 21 项研究。这些研究文章的质量评价参差不齐，主要关注决策中的治疗关系和沟通（30%）、患者在治疗决策中的参与（40%）以及改善患者决策参与的干预措施（30%）。虽然有证据表明共同决策在精神卫生保健中具有前景，但医疗保健提供者利用其沟通技巧来增强治疗关系并使患者参与决策过程非常重要。还需要更多关于支持决策策略及其在精神卫生服务中的实施的高质量研究。
