Shared decision making for adults with severe mental illness: A concept analysis.
Yumi Aoki
PMID 32761783WHAT IT FOUND
For adults with severe mental illness, shared decision making is described as a five-step talk: agree on goals, share options and views, deliberate, reach agreement, then follow up.
It is a concept analysis, not proof this improves care.
Key findings
01The analysis identified five communication phases: goal sharing, information sharing, deliberation, mutual agreement and follow-up.
02Information sharing covered options, pros and cons, research evidence, costs, uncertainties and daily-life impact.
03Broader stakeholders, including nurses as decision coaches and family or carers, were described as part of the process.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a concept analysis, not a trial; it describes how SDM was understood in published articles, not whether it works. The search was limited to English articles from 2010 to November 2019, so relevant work in other languages or earlier or later periods may be missing. It excluded parents or guardians of children with severe mental illness, so it does not address surrogate decision making for children. The included studies varied in setting and decision type, so the themes are not a tested clinical protocol. The authors did not test SDM; reported consequences come from the source articles and may not apply to every patient.
Declared interests
One author received a Japan Society for the Promotion of Science grant and lecture fees from MSD.
The easy way to misread this
Do not read this as evidence that shared decision making improves patient outcomes. It is a concept analysis of how SDM was described in the included articles; it did not test whether SDM works.