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Shared decision making for adults with severe mental illness: A concept analysis
Author(s) -
Aoki Yumi
Publication year - 2020
Publication title -
japan journal of nursing science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.363
H-Index - 17
eISSN - 1742-7924
pISSN - 1742-7932
DOI - 10.1111/jjns.12365
Subject(s) - mental illness , cinahl , bipolar disorder , psychology , deliberation , schizophrenia (object oriented programming) , stakeholder , mental health , clinical psychology , psychiatry , cognition , psychological intervention , public relations , politics , political science , law
Aim Shared decision making for adults with severe mental illness has increasingly attracted attention. However, this concept has not been comprehensively clarified. This review aimed to clarify a concept of shared decision making for adults with severe mental illness such as schizophrenia, depression, and bipolar disorder, and propose an adequate definition. Methods Rodgers' evolutionary concept analysis was used. MEDLINE, PsychINFO, and CINAHL were searched for articles written in English and published between 2010 and November 2019. The search terms were “psychiatr*” or “mental” or “schizophren*” or “depression” or “bipolar disorder”, combined with “shared decision making”. In total, 70 articles met the inclusion criteria. An inductive approach was used to identify themes and sub‐themes related to shared decision making for adults with severe mental illness. Surrogate terms and a definition of the concept were also described. Results Four key attributes were identified: user–professional relationship, communication process, user‐friendly visualization, and broader stakeholder approach. Communication process was the densest attribute, which consisted of five phases: goal sharing, information sharing, deliberation, mutual agreement, and follow‐up. The antecedents as prominent predisposing factors were long‐term complex illness, power imbalance, global trend, users' desire, concerns, and stigma. The consequences included decision‐related outcomes, users' changes, professionals' changes, and enhanced relationship. Conclusions Shared decision making for adults with severe mental illness is a communication process, involving both user‐friendly visualization techniques and broader stakeholders. The process may overcome traditional power imbalance and encourage changes among both users and professionals that could enhance the dyadic relationship.