Measures of Shared Decision Making for People With Mental Disorders and Limited Decisional Capacity: A Systematic Review

Psychiatr Serv. 2023 Nov 1;74(11):1171-1175. doi: 10.1176/appi.ps.202200018. Epub 2023 May 17.

Abstract

Objective: Shared decision making (SDM) is a health communication model to improve treatment decision making and is underused for people with mental health conditions and limited, impaired, or fluctuating decisional capacity. SDM measures are essential to enhancing the adoption and implementation of SDM practices, yet no tools or research findings exist that explicitly focus on measuring SDM with such patients. The aim of this review was to identify instruments that measure SDM involving individuals with mental health conditions and limited decisional capacity, their family members, and their health and social care providers.

Methods: A systematic review was performed by searching the PubMed, Embase, Web of Science, and PsycInfo databases. The authors included peer-reviewed, quantitative articles published in English during 2009-2022 that focused on adults (≥18 years old). All authors performed the screening independently.

Results: A total of 7,956 records were identified, six of which met the inclusion criteria for full-text review and five of which were analyzed (one full-text article was not available). No instruments were identified that measured forms of SDM involving patients with mental health conditions and limited, impaired, or fluctuating decisional capacity.

Conclusions: Measurement instruments to address and assess SDM in health care-related communication processes involving individuals with a mental health condition and limited decisional capacity are needed.

Keywords: Assisted decision making; Capacity; Mental health; Physician-patient relationships; Shared decision making; Supported decision making.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Decision Making
  • Decision Making, Shared*
  • Family
  • Humans
  • Mental Disorders* / therapy
  • Patient Participation