A qualitative analysis of implementing shared decision making in Child and Adolescent Mental Health Services in the United Kingdom: Stages and facilitators

被引：40

作者：

Abrines-Jaume, Neus ^{[1
,2
,3
]}

Midgley, Nick ^{[2
,4
]}

Hopkins, Katy ^{[1
,2
]}

Hoffman, Jasmine ^{[1
,2
]}

Martin, Kate ^{[5
]}

Law, Duncan ^{[6
]}

Wolpert, Miranda ^{[1
,2
]}

机构：

[1] EBPU, Anna Freud Ctr, London NW3 5SU, England

[2] UCL, London, England

[3] London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London WC1, England

[4] Anna Freud Ctr, London, England

[5] Common Room Consulting Ltd, London, England

[6] Child Outcomes Res Consortium, London, England

来源：

CLINICAL CHILD PSYCHOLOGY AND PSYCHIATRY | 2016年 / 21卷 / 01期

关键词：

Shared decision making; child mental health; Child and Adolescent Mental Health Services; plan-do-study-act; implementation; PATIENT PREFERENCES; PARTICIPATION; PHYSICIANS; BARRIERS;

D O I：

10.1177/1359104514547596

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Objectives: To explore the implementation of shared decision making (SDM) in Child and Adolescent Mental Health Services (CAMHS), and identify clinician-determined facilitators to SDM. Methods: Professionals from four UK CAMHS tried a range of tools to support SDM. They reflected on their experiences using plan-do-study-act log books. A total of 23 professionals completed 307 logs, which were transcribed and analysed using Framework Analysis in Atlas.Ti. Results: Three states of implementation (apprehension, feeling clunky, and integration) and three aspects of clinician behavior or approach (effort, trust, and flexibility) were identified. Conclusions: Implementation of SDM in CAMHS requires key positive clinician behaviors, including preparedness to put in effort, trust in young people, and use of the approach flexibly. Practice implications: Implementation of SDM in CAMHS is effortful, and while tools may help support SDM, clinicians need to be allowed to use the tools flexibly to allow them to move from a state of apprehension through a sense of feeling clunky to integration in practice.

引用

页码：19 / 31

页数：13

共 23 条

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