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Rosenberg, D., Schön, U.-K., Nyholm, M., Grim, K. & Svedberg, P. (2017). Shared decision making in community mental health services - an evaluation of three self-reporting instruments. Journal of Mental Health, 26(2), 142-149
Open this publication in new window or tab >>Shared decision making in community mental health services - an evaluation of three self-reporting instruments
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2017 (English)In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 26, no 2, p. 142-149Article in journal (Refereed) Published
Abstract [en]

Background: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.

Aim: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.

Method: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.

Results: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.

Conclusions: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services. © Informa UK Limited, trading as Taylor & Francis Group.

Place, publisher, year, edition, pages
Abingdon, Oxon: Routledge, 2017
Keyword
Recovery, mental illness, questionnaire, shared decision making, reliability, validity
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Identifiers
urn:nbn:se:hh:diva-31791 (URN)10.1080/09638237.2016.1207223 (DOI)000399610500008 ()27452763 (PubMedID)2-s2.0-84979502225 (Scopus ID)
Note

Funding: The National Board of Health and Welfare (Socialstyrelsen), Sweden

Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2018-03-22Bibliographically approved
Grim, K., Rosenberg, D., Svedberg, P. & Schön, U.-K. (2016). Shared decision-making in mental health care – A user perspective on decisional needs in community-based services. International Journal of Qualitative Studies on Health and Well-being, 11, Article ID 30563.
Open this publication in new window or tab >>Shared decision-making in mental health care – A user perspective on decisional needs in community-based services
2016 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30563Article in journal (Refereed) Published
Abstract [en]

Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

Place, publisher, year, edition, pages
Järfälla: Co-Action Publishing, 2016
Keyword
Shared decision-making, information needs, mental healthcare, directed content analysis
National Category
Nursing Sociology
Identifiers
urn:nbn:se:hh:diva-30524 (URN)10.3402/qhw.v11.30563 (DOI)000396163500001 ()27167556 (PubMedID)2-s2.0-84982671669 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2017-11-30Bibliographically approved
Rosenberg, D., Svedberg, P. & Schön, U.-K. (2015). Establishing a Recovery Orientation in Mental Health Services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish Context. Psychiatric rehabilitation journal, 38(4), 328-335
Open this publication in new window or tab >>Establishing a Recovery Orientation in Mental Health Services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish Context
2015 (English)In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 38, no 4, p. 328-335Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context.

METHODS: The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results.

RESULTS: The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. © 2015 APA, all rights reserved

Place, publisher, year, edition, pages
Washington, DC: American Psychological Association (APA), 2015
Keyword
Recovery, recovery-oriented services, serious mental illness, the recovery self-assessment, reliability, validity
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-28762 (URN)10.1037/prj0000150 (DOI)000370393100008 ()26053531 (PubMedID)2-s2.0-84951802497 (Scopus ID)
Available from: 2015-06-23 Created: 2015-06-23 Last updated: 2017-12-04Bibliographically approved
Dahlqvist Jönsson, P., Schön, U.-K., Rosenberg, D., Sandlund, M. & Svedberg, P. (2015). Service users’ experiences of participation in decision making in mental health services. Journal of Psychiatric and Mental Health Nursing, 22(9), 688-697
Open this publication in new window or tab >>Service users’ experiences of participation in decision making in mental health services
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2015 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, no 9, p. 688-697Article in journal (Refereed) Published
Abstract [en]

Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2015
Keyword
grounded theory, severe mental illness, participation, recovery, shared decision-making
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-28763 (URN)10.1111/jpm.12246 (DOI)000362914900005 ()26148016 (PubMedID)2-s2.0-84944179195 (Scopus ID)
Available from: 2015-06-23 Created: 2015-06-23 Last updated: 2017-12-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3866-5636

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