Participation in medical decision-making across Europe: An international longitudinal multicenter study
Open accessAbstract
Background: The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries. Methods: The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations. Results: We found large cross-national differences in patients’ desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P< 0.001). Averaged over time and independent of patient characteristics, London (mean = 2.27), Ulm (mean = 2.13) and Zurich (mean = 2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean = 1.97), where scores were in turn significantly higher than in Debrecen (mean = 1.56). The lowest scores were reported in Naples (mean = 1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b= 0.23) and decreased in Naples (b= −0.14). In all other centers, values remained stable. Conclusions: This study demonstrates that patients’ desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe.
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Patients with severe mental disorders report a greater desire to be involved in clinical decision-making and a need to have a say in the process of care than individuals receiving assistance for other medical conditions.
“This has been especially highlighted in the case of patients with severe mental disorders who report a greater desire of being involved in clinical decision-making and a need to have a say in the process of care, as compared to individuals receiving assistance for other medical conditions [8–11].”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [8]
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- Authors
- Bär Deucher, A., Hengartner, M., Kawohl, W., Konrad, J., Puschner, B., Clarke, E., Slade, M., Del Vecchio, V., Sampogna, G., Égerházi, A., Süveges, Á., Krogsgaard Bording, M., Munk-Jørgensen, P., Rössler, W., & and the CEDAR study group
- Affiliations
- University of Zurich (CH)
- Universität Ulm (DE)
- King's College London (GB)
- University of Debrecen (HU)
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016
- Volume
- 35
- Pages
- 39-46
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2276169960
- Cited by
- 28
- References
- 47
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 1
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc-nd)
- Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) (submittedVersion, cc-by-nc-nd)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Funders
- Università degli Studi di Napoli Federico II
- Aarhus Universitetshospital
- King's College London
- European Commission (223290)
- Universität Zürich
- Universität Ulm
- Debreceni Egyetem
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- patient involvement in treatment decisions, shared decision-making, severe mental illness, cross-national differences, cultural factors, patient preferences
- MeSH terms
- Clinical Decision-Making, Mental Disorders, Decision Making, Europe, Female, Humans, Longitudinal Studies, Male, Middle Aged, Patient Participation, Physician-Patient Relations, Severity of Illness Index, Patient Satisfaction, Quality Indicators, Health Care
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