title: Patients' understanding of shared decision making in a mental health setting.
abstract: Shared decision making is a fundamental component of patient-centered care and has been linked to positive health outcomes. Increasingly, researchers are turning their attention to shared decision making in mental health; however, few studies have explored decision making in these settings from patients' perspectives. We examined patients' accounts and understanding of shared decision making. We analyzed interviews from 54 veterans receiving outpatient mental health care at a Department of Veterans Affairs Medical Center in the United States. Although patients' understanding of shared decision making was consistent with accounts published in the literature, participants reported that shared decision making goes well beyond these components. They identified the patient-provider relationship as the bedrock of shared decision making and highlighted several factors that interfere with shared decision making. Our findings highlight the importance of the patient-provider relationship as a fundamental element of shared decision making and point to areas for potential improvement.
authors.affiliation: Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA Johanne.eliacin@va.gov.
authors.forename: Johanne
authors.initials: J
authors.lastname: Eliacin
authors.affiliation: Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Salyers
authors.affiliation: Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Kukla
authors.affiliation: Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA Regenstrief Institute, Indianapolis, Indiana, USA.
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Matthias
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008605:Mental Health Services; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
keywords: communication; decision making; mental health and illness; relationships, health care; research, qualitative