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Triadic shared decision making in emergency psychiatry: an explorative study.

G C Roselie van Asperen1,2, R F P de Winter3,4,5, C L Mulder6,7

  • 1Parnassia Psychiatric Institute, Dynamostraat 18, Rotterdam, 3083 AK, the Netherlands. r.vanasperen@parnassiagroep.nl.

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Summary
This summary is machine-generated.

Shared decision-making in psychiatric emergency services often reaches consensus on inpatient or outpatient care. However, patient preferences can diverge, influencing treatment choices post-triage.

Keywords:
Acute mental health careEmergency psychiatryInpatient careOutpatient careTriadic shared decision making

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Area of Science:

  • Psychiatry
  • Decision Sciences
  • Health Services Research

Background:

  • Investigates shared decision-making in psychiatric emergency services.
  • Focuses on post-triage inpatient vs. outpatient care decisions.
  • Examines instances where patient or significant other preferences override clinical judgment.

Purpose of the Study:

  • To understand the triadic shared decision-making process in psychiatric emergency care.
  • To identify factors influencing the choice between inpatient and outpatient treatment.
  • To explore scenarios of preference override in psychiatric care.

Main Methods:

  • Explorative study conducted in the greater Rotterdam area, Netherlands.
  • Surveyed patient, significant other, and professional preferences for admission/outpatient care.
  • Utilized descriptive statistics and preference categorization to analyze agreement patterns.

Main Results:

  • Among 5680 assessments, 48.2% showed triad agreement on care type.
  • Patient disagreement occurred in 38.5% of cases; significant others disagreed in 11.0%.
  • Professional recommendations were followed 57.0% of the time, patient preferences 9.4%, and significant others' 11.0%.

Conclusions:

  • Consensus on inpatient or outpatient care is frequently achievable post-triage.
  • Disagreements arise when patient/significant other preferences conflict with others'.
  • Professional recommendations are influential but can be overridden, especially for involuntary care.