A meta-ethnography of shared decision-making in mental health care from the perspective of staff and service users.

Autor: Cartwright C; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK., Greenhill B; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK. E.Greenhill@liverpool.ac.uk.; Eleanor Rathbone Building, The University of Liverpool, Bedford Street South, Liverpool, L69 7ZA, UK. E.Greenhill@liverpool.ac.uk., Griffiths AW; Department of Neuroscience, University of Sheffield, Sheffield, UK., Harrison J; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2024 Sep 27; Vol. 24 (1), pp. 1142. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1186/s12913-024-11540-9
Abstrakt: Background: Human rights, recovery, and value-based approaches are integral to strategic changes and development in mental health care. Successfully integrating such person-centred values in mental health services requires a paradigm shift from traditional biomedical models of care to a more human rights-based approach. An important aspect of this is shared decision making (SDM) between mental health staff and service users. Whilst it is widely acknowledged SDM leads to improved outcomes, there are barriers and challenges to implementing this approach effectively in clinical practice.
Objectives: This systematic review aimed to assess existing empirical research exploring mental health service users and/or staff's attitudes towards and experiences of SDM in adult mental health care settings.
Methods: The review and protocol were registered on PROSPERO (CRD42023369472). Systematic searches were run on four databases. Search terms pertained to studies reporting on mental health staff or service users' experiences of SDM in adult mental health care. Initial searches yielded 721 results. Included studies were analysed using a meta-ethnographic approach.
Results: Thirteen articles were included. Data were synthesised using meta ethnographic synthesis, which produced four higher order themes with related subthemes; the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinicians' behaviours and attitudes.
Implications: Both staff and service users found SDM to be an important factor in delivering high quality, effective mental health care. Despite this, participants had very little experience of implementing SDM in practice due to several personal, professional, and organisational challenges. This suggests that differences exist between what services strive towards achieving, and the experience of those implementing this in practice. These findings suggest that further research needs to be conducted to fully understand the barriers of implementing SDM in mental health services with training delivered to staff and service users about SDM.
(© 2024. The Author(s).)
Databáze: MEDLINE
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