Shared decision making for adults with severe mental illness: A concept analysis.

Area of Science:

• Mental Health Research
• Healthcare Communication
• Patient-Centered Care

Background:

• Shared decision making (SDM) is gaining traction for adults with severe mental illness (SMI).
• The concept of SDM in SMI requires comprehensive clarification.
• Existing literature lacks a clear definition of SDM tailored to SMI populations.

Purpose of the Study:

• To clarify the concept of SDM for adults with severe mental illness (SMI).
• To propose an adequate definition of SDM for SMI.
• To identify key attributes, antecedents, and consequences of SDM in SMI.

Main Methods:

• Utilized Rodgers' evolutionary concept analysis.
• Conducted a systematic literature search of MEDLINE, PsychINFO, and CINAHL (2010-2019).
• Included 70 articles using terms related to psychiatric/mental health conditions and SDM; employed an inductive approach.

Main Results:

• Identified four key attributes: user-professional relationship, communication process, user-friendly visualization, and broader stakeholder approach.
• The communication process encompasses five phases: goal sharing, information sharing, deliberation, mutual agreement, and follow-up.
• Antecedents include illness complexity, power imbalance, and stigma; consequences involve decision outcomes and relationship enhancement.

Conclusions:

• SDM in SMI is a communication process integrating visualization and stakeholder involvement.
• This process can mitigate power imbalances and foster positive changes in users and professionals.
• SDM has the potential to enhance the dyadic relationship between users and healthcare providers.