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Background: People with depression should be actively involved in deciding what treatment they are prescribed. In order to facilitate informed decision-making, healthcare professionals need to be aware of, and respond to the decision-making issues patients find important. Whilst a number of factors have been related to particular treatment decisions in depression, little is known about how these factors relate to each other and how influential people think they are in relation to treatment decision-making. Aim: To better understand what factors influence treatment decisions made by depressed people. Method: Using concept mapping, an established mixed methods design, I collected and compared the views of patients (n=28), their family and friends (n=14) and healthcare workers (n=22). The method involves three data collection tasks. 1. Brainstorming – within the group or in individual sessions, participants brainstorm about the factors that influence treatment decisions made by depressed people. The factors are recorded as individual ‘statements’, and pooled at the end of the phase in order to be reviewed and reduced to below 98. All participants are invited again to take part in the following tasks. 2. Clustering – participants individually put together into groups the statements that they consider to be related based on their own criteria. 3. Prioritising – participants individually rank their perceived relative importance of each statement with regards to its effect on patients’ treatment decisions. Results: The three stakeholder groups differed significantly in their opinions about which factors they considered to be most influential l of patients’ treatment decisions. These factors included patients’ insight, emotional states (i.e. how I feel right now), external views about depression (stigma) and doctors’ advice. I also identified five subgroups of patients with depression who differed significantly in their views about how they make treatment decisions. Conclusion: To facilitate more considered decisions about depression treatment, mental health professionals need to better understand how treatment choices are made. Health professionals should be more vigilant to the differences of individual patients. |
