title: Empowerment and satisfaction in a multinational study of routine clinical practice.
abstract: OBJECTIVE
  Decision-making between mental health clinicians and patients is under-researched. We tested whether mental health patients are more satisfied with a decision made (i) using their preferred decision-making style and (ii) with a clinician with the same decision-making style preference.
  
  
  METHODS
  As part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction.
  
  
  RESULTS
  Patients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, P=0.005, 95% CI 1.32-4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, P=0.003, 95% CI 1.48-6.82).
  
  
  CONCLUSIONS
  More active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction.
authors.affiliation: King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Clarke
authors.forename: B
authors.initials: B
authors.lastname: Puschner
authors.forename: H
authors.initials: H
authors.lastname: Jordan
authors.forename: P
authors.initials: P
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Konrad
authors.forename: W
authors.initials: W
authors.lastname: Kawohl
authors.forename: A
authors.initials: A
authors.lastname: Bär
authors.forename: W
authors.initials: W
authors.lastname: Rössler
authors.forename: V
authors.initials: V
authors.lastname: Del Vecchio
authors.forename: G
authors.initials: G
authors.lastname: Sampogna
authors.forename: M
authors.initials: M
authors.lastname: Nagy
authors.forename: A
authors.initials: A
authors.lastname: Süveges
authors.forename: M
authors.initials: M
authors.lastname: Krogsgaard Bording
authors.forename: M
authors.initials: M
authors.lastname: Slade
mesh_terms: D000328:Adult; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data; D057240:Patient Preference; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D058996:Quality Improvement; D011795:Surveys and Questionnaires
keywords: decision-making; mental health