title: What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists.
abstract: OBJECTIVE
  Patient involvement in decision making is endorsed by patients and professionals. While research has recently been conducted on how professionals can promote shared decision making (SDM), little is known about how patients can also facilitate SDM.
  
  
  METHODS
  Seven focus groups were conducted: 3 with psychiatrists and 4 with patients with schizophrenia or depression. The focus groups were transcribed and independently coded line by line by 2 researchers. Data were analyzed using content analysis.
  
  
  RESULTS
  Seven themes related to patient attitudes and behaviors were identified: honesty and openness with one's psychiatrist and oneself, trust in one's psychiatrist and patience with the treatment, respect and politeness, informing the psychiatrist and giving feedback, engagement/active participation during the consultation, gathering information/preparing for the consultation and implementing decisions. Barriers (e.g., avolition, lack of decisional capacity, powerlessness during involuntary treatment) and facilitators of active patient behavior were also identified.
  
  
  CONCLUSIONS
  There are various ways in which patients can facilitate SDM/play a more active role in decision making, with patients emphasizing being open and honest and psychiatrists emphasizing being active in the consultation. Interventions to increase active patient behavior may enhance SDM in mental health care.
authors.affiliation: Psychiatric Department, Technische Universität München, Munich, Germany. j.hamann@lrz.tum.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hamann
authors.affiliation: Psychiatric Department, Technische Universität München, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Kohl
authors.affiliation: University of Exeter Medical School, Exeter, UK.
authors.forename: R
authors.initials: R
authors.lastname: McCabe
authors.affiliation: Department for Psychology, Ludwig-Maximilian-Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bühner
authors.affiliation: Psychiatric Department, Technische Universität München, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Mendel
authors.affiliation: Isar Amper Klinikum München Ost, kbo, Haar, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Albus
authors.affiliation: Isar Amper Klinikum München Ost, kbo, Haar, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bernd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003657:Decision Making; D003863:Depression / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D011570:Psychiatry; D036301:Qualitative Research; D012559:Schizophrenia / Q000628:therapy*; D055815:Young Adult
keywords: Adherence; Depression; Patient autonomy; Schizophrenia; Shared decision making