Johanne Eliacin1, Michelle P Salyers, Marina Kukla, Marianne S Matthias. 1. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development, Center for Health Information and Communication, Richard L. Roudebush VA Medical Center , Indianapolis, IN , USA .
Abstract
BACKGROUND: Although research has suggested that patients desire to participate in shared decision-making, recent studies show that most patients take a passive role in their treatment decisions. The discrepancy between patients' expressed desire and actual behaviors underscores the need to better understand how patients perceive shared decision-making and what factors influence their participation. AIMS: To investigate patients' preferences and appraisals of their involvement in treatment decisions. METHODS: Fifty-four qualitative interviews were conducted with veterans receiving outpatient mental health care at a U.S. Veterans Affairs Medical Center. Interviews were analyzed using thematic analysis. RESULTS: Participants outlined several factors that influence their preferences and involvement in treatment decisions. These include the patient-provider relationship, fear of being judged, perceived inadequacy, and a history of substance abuse. CONCLUSION: Patients' preferences and willingness to engage in shared decision-making fluctuate over time and are context dependent. A better understanding of these factors and a strong patient-provider relationship will facilitate better measurement and implementation of shared decision-making.
BACKGROUND: Although research has suggested that patients desire to participate in shared decision-making, recent studies show that most patients take a passive role in their treatment decisions. The discrepancy between patients' expressed desire and actual behaviors underscores the need to better understand how patients perceive shared decision-making and what factors influence their participation. AIMS: To investigate patients' preferences and appraisals of their involvement in treatment decisions. METHODS: Fifty-four qualitative interviews were conducted with veterans receiving outpatient mental health care at a U.S. Veterans Affairs Medical Center. Interviews were analyzed using thematic analysis. RESULTS: Participants outlined several factors that influence their preferences and involvement in treatment decisions. These include the patient-provider relationship, fear of being judged, perceived inadequacy, and a history of substance abuse. CONCLUSION: Patients' preferences and willingness to engage in shared decision-making fluctuate over time and are context dependent. A better understanding of these factors and a strong patient-provider relationship will facilitate better measurement and implementation of shared decision-making.
Entities:
Keywords:
Mental health; patient’s preferences and participation; shared decision-making; veterans
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