Olsena Solvita, Stars Inese, Rozenberga Elza Eliza, Konstantinova Karina, Baidina Ksenija
Faculty of Medicine and Life Sciences, University of Latvia, LV-1004 Riga, Latvia.
Healthcare (Basel). 2025 Jun 13;13(12):1416. doi: 10.3390/healthcare13121416.
BACKGROUND/OBJECTIVES: Decision making is fundamental to personal autonomy and person-centered, rights-based psychiatric care. This study explored the perceptions and experiences of decision making in psychiatric care from the perspectives of service users, caregivers, and healthcare professionals, identifying contexts that facilitate or hinder these practices.
An exploratory-descriptive qualitative design was applied, using semi-structured interviews with eight service users, six caregivers, and seven healthcare professionals (21 interviews in total). Data were transcribed verbatim and analyzed through inductive content analysis.
Four main categories were identified: (1) antecedents for decision making, (2) challenges in decision making, (3) consequences of decision making, and (4) recommendations for improvement.
This study provides insight into how decisions in psychiatric care are made in Latvia, highlighting the legal, personal, and institutional factors influencing these processes. Participants offered valuable perspectives, identifying both facilitators and barriers to autonomous decision making, as well as suggesting necessary improvements. The findings suggest the need for legal reform and systemic improvements in practices that favor agency in decision making. Additionally, they underscore the importance of strengthening individual capacities to support meaningful collaboration among service users, caregivers, and healthcare professionals in making healthcare decisions that enhance the quality of care and well-being of people with mental health difficulties.
背景/目标：决策对于个人自主权以及以个人为中心、基于权利的精神科护理至关重要。本研究从服务使用者、护理人员和医疗保健专业人员的角度探讨了精神科护理中决策的认知和体验，确定了促进或阻碍这些做法的背景情况。
采用探索性描述性定性设计，对8名服务使用者、6名护理人员和7名医疗保健专业人员进行半结构化访谈（共21次访谈）。数据逐字转录，并通过归纳性内容分析进行分析。
确定了四个主要类别：（1）决策的前提条件，（2）决策中的挑战，（3）决策的后果，以及（4）改进建议。
本研究深入了解了拉脱维亚精神科护理中决策是如何做出的，突出了影响这些过程的法律、个人和机构因素。参与者提供了宝贵的观点，确定了自主决策的促进因素和障碍，并提出了必要的改进建议。研究结果表明需要进行法律改革并在有利于决策自主性的实践中进行系统性改进。此外，这些结果强调了加强个人能力以支持服务使用者、护理人员和医疗保健专业人员之间有意义的合作，从而做出能够提高心理健康问题患者护理质量和福祉的医疗决策的重要性。
