title: Why are you here again? Concordance between consumers and providers about the primary concern in recurring psychiatric visits.
abstract: Patient-centered care has become increasingly important over the last decade, both in physical and mental health care. In support of patient-centered care, providers need to understand consumers׳ primary concerns during treatment visits. The current study explored what primary concerns were brought to recurring psychiatric visits for a sample of adults with severe mental illness (N=164), whether these concerns were concordant with those recognized by providers, and which factors predicted concordance. We identified 17 types of primary concerns, most commonly medications and symptoms, with only 50% of visits showing evidence of at least partial agreement between consumers and providers. Contrary to expectations, consumer demographics, activation, trust, and perceptions of patient-centeredness were not predictive, while greater preferences for autonomy predicted poorer agreement. Our findings highlight the need for interventions to promote a shared understanding of primary concerns in recurring psychiatric visits. Further attention is needed to ensure the provision of patient-centered care such that consumer concerns are acknowledged and addressed within recurring psychiatric visits.
authors.affiliation: Psychology Department, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; ACT Center of Indiana, Indianapolis, IN, USA. Electronic address: kbonfils@iupui.edu.
authors.forename: Kelsey A
authors.initials: KA
authors.lastname: Bonfils
authors.affiliation: The University of Kansas School of Social Welfare Center for Mental Health Research and Innovation, Lawrence, KS, USA.
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Psychology Department, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; ACT Center of Indiana, Indianapolis, IN, USA.
authors.forename: Erin L
authors.initials: EL
authors.lastname: Adams
authors.affiliation: Psychology Department, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; ACT Center of Indiana, Indianapolis, IN, USA.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Hedrick
authors.affiliation: Psychology Department, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; ACT Center of Indiana, Indianapolis, IN, USA.
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Salyers
mesh_terms: D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged; D010358:Patient Participation; D018802:Patient-Centered Care; D012008:Recurrence
keywords: Communication; Patient-centered care; Severe mental illness; Shared decision-making