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IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-04-07 DOI:10.1111/hex.70239

Lien Mertens, Joris Vandenberghe, Geertruida Bekkering, Karin Hannes, Nicolas Delvaux, Pieter Van Bostraeten, Jasmien Jaeken, Bert Aertgeerts, Mieke Vermandere

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引用次数: 0

摘要

背景在精神医疗保健中使用共同决策（SDM）被认为至少与在非精神医疗保健环境中使用同样重要，但在精神医疗保健环境中仍未经常使用。为了进一步探索有生活经验者的 SDM 流程，我们提供了一份定性荟萃摘要，内容涉及患者报告的在精神医疗背景下参与 SDM 的障碍和促进因素。研究方法我们利用五个数据库，在为更大规模的定性元总结而挑选的研究中，选出了对精神疾病患者进行调查的研究，以便在本文中进行进一步分析。检索词基于以下概念："决策"、"患者参与"、"患者感知 "和患者报告的 "研究设计"，包括患者调查、访谈和焦点小组。结果在 90 篇被选入大型综述的研究中，我们选择了 13 篇与精神疾病有关的文章在本综述中进行更详细的分析。我们总共发现了 29 个不同的影响因素，并发现了 6 个主要障碍："缺乏选择"、"人格不被尊重"、"感觉受到医生的侮辱"、"疾病负担"、"权力不平衡 "和 "参与的自我效能低"。提供清晰的选择信息"、"作为一个人受到尊重，被考虑"、"良好的医患关系 "和 "相信自己角色的重要性 "是主要的促进因素。结论在精神卫生保健领域，污名化和自我污名化似乎依然存在，并继续抑制着患者参与 SDM 的自我效能。全世界都在讨论包容性和多样性，这些主题对于有精神健康问题的患者来说也同样具有现实意义。在这种情况下，似乎有必要开展进一步的工作，以消除所有的污名化和自我污名化，努力实现 "尽可能共享 "的护理。患者和公众的贡献作者在此感谢沃尔特-盖恩斯（Walter Geuens）先生，他是一位在精神卫生保健方面有着丰富经验的人士，感谢他对最终论文的仔细阅读和全面反馈。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Navigating Power Imbalances and Stigma in Mental Healthcare. Patient-Reported Barriers and Facilitators to Participation in Shared Decision-Making in Mental Health Care, a Qualitative Meta-Summary

查看原文本刊更多论文

Navigating Power Imbalances and Stigma in Mental Healthcare. Patient-Reported Barriers and Facilitators to Participation in Shared Decision-Making in Mental Health Care, a Qualitative Meta-Summary

Background

The use of shared decision-making (SDM) in mental healthcare has been viewed as at least as important as its use in non-mental healthcare settings, but it still does not routinely take place in this setting. To further explore SDM processes with people with lived experience, we provide a qualitative meta-summary on patient-reported barriers and facilitators to participation in SDM within the context of mental healthcare.

Methods

Within the set of selected studies for a larger qualitative meta-summary, using five databases, we selected the studies that had surveyed patients with mental illness for further analysis in this paper. Search terms were based on the concepts: ‘decision making’, ‘patient participation’, ‘patient perceptions’ and ‘study design’ of patient reporting, including patient surveys, interviews and focus groups.

Results

Out of the 90 studies that had been selected for the larger review, we selected 13 articles concerning mental illness for more detailed analysis in this review. In total, we identified 29 different influencing factors and we found 6 major barriers: ‘Lack of choice’, ‘Not being respected as a person’, ‘Feeling stigma from physician’, ‘Disease burden’, ‘Power imbalance’ and ‘Low self-efficacy to participate’. ‘Clear information provision about options’, ‘Being respected as a person, being taken into account’, ‘Good physician-patient relationship’ and ‘Belief in the importance of one's own role’ were the main facilitators.

Conclusions

Stigma and self-stigma still seem to persist in mental healthcare and continue to suppress patients' self-efficacy to participate in SDM in this setting. There is much discussion of inclusion and diversity worldwide, and these themes are just as topical for patients with mental health problems. Further work seems necessary to eradicate all stigma and self-stigma in this setting when striving for care that could be ‘as shared as possible’.

Patient and Public Contribution

The authors wish to thank Mr. Walter Geuens, a person with lived experience in mental healthcare, for his careful reading and thorough feedback on the final paper.

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.