Conceptual understanding and applicability of shared decision-making in psychiatric care: An integrative review

INTRODUCTION: Patient involvement in decisions regarding treatment has increasingly been supported in health care and therefore shared decision making (SDM), as an informative and participative approach, is promoted in the scientific literature. AIM: To review the current state of research regarding the conceptual understanding and implementation of SDM in psychiatric clinical practice. METHOD: An integrative review that included empirical, theoretical and conceptual research published between 1997 and 2019 was conducted. For this, five health-related databases were searched. RESULTS: Fourteen articles were included in the synthesis. No universal conceptual understanding of SDM regarding psychiatric care could be identified, although several articles highlighted the link with other concepts, such as autonomy and patient-centeredness. Furthermore, four additional key themes with relevance for the successful implementation of SDM in clinical practice were determined. DISCUSSION: SDM refers to a process and is usually not limited to a single consultation. SDM shows the potential to enhance patient-centered and recovery-oriented care. A collaborative approach including multiple health professionals, peer workers and family members is required. IMPLICATIONS FOR PRACTICE: The process of SDM should be made visible for all parties involved. Nurses in particular could play a key role by collecting information regarding patient's preferences and by providing support.