Empowerment and satisfaction in a multinational study of routine clinical practice

Acta Psychiatr Scand. 2015 May;131(5):369-78. doi: 10.1111/acps.12365. Epub 2014 Dec 4.

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.

Method: 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).

Conclusion: 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.

Keywords: decision-making; mental health.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Europe
  • Female
  • Humans
  • Male
  • Mental Disorders* / psychology
  • Mental Disorders* / therapy
  • Mental Health Services / standards
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Patient Participation* / psychology
  • Patient Participation* / statistics & numerical data
  • Patient Preference
  • Personal Satisfaction
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Quality Improvement
  • Surveys and Questionnaires

Associated data

  • ISRCTN/ISRCTN75841675