A critical narrative analysis of shared decision-making in acute inpatient mental health care
| Autor: | Bob Diamond, Martin E.H. Willis, Alastair Morgan, John Dumenya, Beverley Johnson, Philip Houghton, Gemma Stacey, Theo Stickley, Anne Felton |
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| Rok vydání: | 2016 |
| Předmět: |
Attitude of Health Personnel
Interprofessional Relations Mental Disorders Applied psychology Identity (social science) Context (language use) General Medicine Focus Groups Affect (psychology) Focus group Mental health 030227 psychiatry Narrative inquiry 03 medical and health sciences Interpersonal relationship 0302 clinical medicine Nursing Patient-Centered Care Humans 030212 general & internal medicine Cooperative Behavior Patient Participation Patient participation Psychology |
| Zdroj: | Journal of Interprofessional Care. 30:35-41 |
| ISSN: | 1469-9567 1356-1820 |
| DOI: | 10.3109/13561820.2015.1064878 |
| Popis: | Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place. |
| Databáze: | OpenAIRE |
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