ArticleBMJ open2022
Implementation and staff understanding of shared decision-making in the context of recovery-oriented care across US Veterans Health Administration (VHA) inpatient mental healthcare units: a mixed-methods evaluation.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Veterans' views of PARTNER-MH, a peer-led patient navigation intervention, to improve patient engagement in care and patient-clinician communication: A qualitative study.Patient education and counseling · 2023Trial
- From Idealist to Realist-Designing and Implementing Shared Decision-Making Interventions in the Choice of Antipsychotic Prescription in People Living with Psychosis (SHAPE): A Realist Review.Schizophrenia bulletin · 2025Review
- Review
- Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis.International journal of environmental research and public health · 2023Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo examine the understanding and practice of shared decision-making (SDM) within the context of recovery-oriented care across Veterans Health Administration (VHA) inpatient mental healthcare units.
designVHA inpatient mental health units were scored on the Recovery-Oriented Acute Inpatient Scale (RAIN). Scores on the RAIN item for medication SDM were used to rank each site from lowest to highest. The top 7 and bottom 8 sites (n=15) were selected for additional analyses using a mixed-methods approach, involving qualitative interviews, observation notes and quantitative data.
setting34 VHA inpatient mental health units located in every geographical region of the USA.
participants55 treatment team members.
resultsOur results identified an overarching theme of 'power-sharing' that describes participants' conceptualisation and practice of medication decision-making. Three levels of power sharing emerged from both interview and observational data: (1)
conclusionsImplementation of SDM appears feasible in acute inpatient mental health units. Although most participants were well informed about SDM, that knowledge did not always translate into practice, which supports the need for ongoing implementation support for SDM. Additional contextual factors underscore the value of patients' self-determination as a guiding principle for SDM, highlighting the role of a supporting, empowering and autonomy-generating environment.
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