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Decisional conflict in mental health care: a cross-sectional study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Decisional conflict refers to the degree to which patients are engaged in and feel comfortable about important clinical decisions. Until now, the concept has received little attention in mental health care. We investigate the level of decisional conflict in mental health care and whether this is influenced by socio-demographics, treatment setting, diagnoses, and locus of control.

Methods

Cross-sectional study among 186 patients in Dutch specialist mental health care using the Decisional Conflict Scale, which measures five dimensions of decisional conflict: information, support, clarification of values, certainty, and decisional quality. Descriptive statistics and forward stepwise linear regression analyses were used.

Results

Patients report relatively high levels of decisional conflict, especially those with more external locus of control. Having a personality disorder and higher education also increases decisional conflict on the dimensions support and clarification of values, respectively. Less decisional conflict was experienced by patients with psychotic disorders on the dimension certainty and by women on the information domain.

Conclusions

Decisional conflict is common among patients in specialist mental health care and is very useful for assessing the quality of clinical decision making. Measuring decisional conflict and knowledge about influencing factors can be used to improve patients’ participation in clinical decision making, adherence to treatment and clinical outcomes.

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Acknowledgements

The authors would like to thank the colleagues of the department of data management and research of GGZ inGeest for their support in the data collection. We also thank the participating patients and organisations for their contribution to the study.

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Authors and Affiliations

  1. GGz Breburg, Postbus 770, 5000, AT, Tilburg, The Netherlands

    Margot J. Metz & Christina M. van der Feltz-Cornelis

  2. Trimbos Institute, Postbus 725, 3500, AS, Utrecht, The Netherlands

    Margot J. Metz & Marjolein A. Veerbeek

  3. VU University, De Boelelaan 1105, 1081, HV, Amsterdam, The Netherlands

    Margot J. Metz

  4. Tilburg University, Postbus 90153, 5000, LE, Tilburg, The Netherlands

    Christina M. van der Feltz-Cornelis

  5. Foundation for Benchmarking Mental Health Care, Rembrandtlaan 46, 3723, BK, Bilthoven, The Netherlands

    Edwin de Beurs

  6. University of Leiden, Postbus 9500, 2300, RA, Leiden, The Netherlands

    Edwin de Beurs

  7. GGZ inGeest, A.J. Ernststraat 1187, 1081, HL, Amsterdam, The Netherlands

    Aartjan T. F. Beekman

  8. VU University Medical Centre Amsterdam, Postbus 7057, 1007, MB, Amsterdam, The Netherlands

    Aartjan T. F. Beekman

Authors
  1. Margot J. Metz
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  2. Marjolein A. Veerbeek
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  3. Christina M. van der Feltz-Cornelis
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  4. Edwin de Beurs
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  5. Aartjan T. F. Beekman
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Corresponding author

Correspondence to Margot J. Metz.

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Funding

This study was supported by the National Network for Quality Development in mental health care (Grant number PV140003).

Conflict of interest

The authors declare that they have no conflict of interest.

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Metz, M.J., Veerbeek, M.A., van der Feltz-Cornelis, C.M. et al. Decisional conflict in mental health care: a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 53, 161–169 (2018). https://doi.org/10.1007/s00127-017-1467-9

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  • DOI: https://doi.org/10.1007/s00127-017-1467-9

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