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What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists

Hamann, J., Kohl, S., McCabe, R. ORCID: 0000-0003-2041-7383 , Bühner, M., Mendel, R., Albus, M. & Bernd, J. (2016). What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists. Social Psychiatry and Psychiatric Epidemiology, 51(4), pp. 617-625. doi: 10.1007/s00127-015-1089-z


Patient involvement in decision making is endorsed by patients and professionals. While research has recently been conducted on how professionals can promote shared decision making (SDM), little is known about how patients can also facilitate SDM.

Seven focus groups were conducted: 3 with psychiatrists and 4 with patients with schizophrenia or depression. The focus groups were transcribed and independently coded line by line by 2 researchers. Data were analyzed using content analysis.

Seven themes related to patient attitudes and behaviors were identified: honesty and openness with one’s psychiatrist and oneself, trust in one’s psychiatrist and patience with the treatment, respect and politeness, informing the psychiatrist and giving feedback, engagement/active participation during the consultation, gathering information/preparing for the consultation and implementing decisions. Barriers (e.g., avolition, lack of decisional capacity, powerlessness during involuntary treatment) and facilitators of active patient behavior were also identified.

There are various ways in which patients can facilitate SDM/play a more active role in decision making, with patients emphasizing being open and honest and psychiatrists emphasizing being active in the consultation. Interventions to increase active patient behavior may enhance SDM in mental health care.

Publication Type: Article
Additional Information: This is a post-peer-review, pre-copyedit version of an article published in Social Psychiatry and Psychiatric Epidemiology. The final authenticated version is available online at:
Publisher Keywords: Shared decision making, Patient autonomy, Adherence, Schizophrenia, Depression
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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