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Review
. 2020 Oct;17(4):e12365.
doi: 10.1111/jjns.12365. Epub 2020 Aug 5.

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

Yumi Aoki  1
Affiliations
Review

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

Yumi Aoki. Jpn J Nurs Sci. 2020 Oct.

Abstract

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.

Keywords: bipolar disorder; depression; review; schizophrenia; shared decision making.

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Conflict of interest statement

Y.A. has received the Japan Society for the Promotion of Science‐in‐Aid for Scientific Research and lecture fees from MSD.

Figures

FIGURE 1
FIGURE 1
Flow chart of article selection
FIGURE 2
FIGURE 2
Concept model of shared decision making for adults with severe mental illness
See this image and copyright information in PMC

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