title: Predictors of shared decision making and level of agreement between consumers and providers in psychiatric care.
abstract: The purpose of this study was to quantitatively examine elements of shared decision making (SDM), and to establish empirical evidence for factors correlated with SDM and the level of agreement between consumer and provider in psychiatric care. Transcripts containing 128 audio-recorded medication check-up visits with eight providers at three community mental health centers were rated using the Shared Decision Making scale, adapted from Braddock's Informed Decision Making Scale (Braddock et al. 1997, 1999, 2008). Multilevel regression analyses revealed that greater consumer activity in the session and greater decision complexity significantly predicted the SDM score. The best predictor of agreement between consumer and provider was "exploration of consumer preference," with a four-fold increase in full agreement when consumer preferences were discussed more completely. Enhancing active consumer participation, particularly by incorporating consumer preferences in the decision making process appears to be an important factor in SDM.
authors.affiliation: Center for Research Methods and Data Analysis, School of Social Welfare, Office of Mental Health Research and Training, The University of Kansas, 1315 Wakarusa, Dr. Lawrence, KS, 66049, USA, fsadaaki@ku.edu.
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Fukui
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Salyers
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Matthias
authors.forename: Linda
authors.initials: L
authors.lastname: Collins
authors.forename: John
authors.initials: J
authors.lastname: Thompson
authors.forename: Melinda
authors.initials: M
authors.lastname: Coffman
authors.forename: William C
authors.initials: WC
authors.lastname: Torrey
mesh_terms: D000328:Adult; D003155:Community Mental Health Centers / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000628:therapy; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013637:Tape Recording