Shared decision-making and information needs among people with generalized anxiety disorder

  1. Vanesa Ramos-García 1
  2. Amado Rivero-Santana 2
  3. Andrea Duarte-Díaz 1
  4. Lilisbeth Perestelo-Pérez 3
  5. Wenceslao Peñate-Castro 1
  6. Yolanda Álvarez-Pérez 4
  7. Ana Isabel González-González 5
  8. Pedro Serrano-Aguilar 3
  1. 1 Faculty of Health Sciences, University of La Laguna
  2. 2 REDISSECCanary Islands Health Research Institute Foundation
  3. 3 Red de Investigación de Servicios de Salud en Enfermedades Crónicas
    info

    Red de Investigación de Servicios de Salud en Enfermedades Crónicas

    Madrid, España

  4. 4 Canary Islands Health Research Institute Foundation
  5. 5 Institute of General Practice, Goethe University
Revista:
EJIHPE: European Journal of Investigation in Health, Psychology and Education

ISSN: 2174-8144 2254-9625

Ano de publicación: 2021

Volume: 11

Número: 2

Páxinas: 423-435

Tipo: Artigo

Outras publicacións en: EJIHPE: European Journal of Investigation in Health, Psychology and Education

Resumo

Shared decision making (SDM) aims to involve patients in the decisions about their care, considering their preferences, values and concerns about the different treatment options. However, research shows that people with mental health problems have considerable unmet information needs about their condition. This community-based cross-sectional study explores the SDM process and information needs among people with Generalized Anxiety Disorder (GAD), as an initial step in the design and development of a Patient Decision Aid for this population. Seventy participants completed an online survey with the Control Preference Scale, and questions about the perceived difficulty of past treatment decisions and the use of the Internet for searching for GAD-related information. Most participants preferred an active (42.9%) or collaborative role (41.4%) in the SDM process, and 53% did not perceive their preferred role. Information provided by healthcare professionals was considered insufficient by 28% of the sample, and over 30% reported using the Internet to look for GAD-related information at least once a week or more. The most relevant GAD-related information needs were general information (71.4%), information on self-help groups (65.7%), recommendations on how to face this disorder (61.4%) and information on treatment options (50%). Exploratory analyses showed that patients who perceived an active participation were more likely to search for information frequently (p = 0.038), and those who felt more involved than desired tended to search for more themes (p = 0.049). In summary, the study showed that a considerable percentage of GAD patients have unmet needs related to decision-making participation and information.

Referencias bibliográficas

  • World Health Organization. Mental Health in the Workplace. Available online: https://www.who.int/mental_health/es/ (accessed on 22 February 2021).
  • World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Available online: https://apps.who.int/iris/handle/10665/254610 (accessed on 22 February 2021).
  • American Psychiatric Association. Diagnostic and Stadistical Manual of Mental Disorders: DSM-V, 5th ed.; American Psychiatric Association: Washington, DC, USA, 2013; Volume 21.
  • Cuijpers, P.; Sijbrandij, M.; Koole, S.; Huibers, M.; Berking, M.; Andersson, G. Psychological treatment of generalized anxiety disorder: A meta-analysis. Clin. Psychol. Rev. 2014, 34, 130–140.
  • Fumero, A.; Peñate, W.; Oyanadel, C.; Porter, B. The Effectiveness of Mindfulness-Based Interventions on Anxiety Disorders. A Systematic Meta-Review. Eur. J. Investig. Health Psychol. Educ. 2020, 10, 704–719.
  • National Institute for Health and Care Excellence (NICE). Generalised Anxiety Disorder and Panic Disorder in Adults: Management. Available online: https://www.nice.org.uk/guidance/cg113/chapter/1-Guidance#stepped-care-for-people-with-gad (accessed on 22 February 2021).
  • Carl, E.; Witcraft, S.M.; Kauffman, B.Y.; Gillespie, E.M.; Becker, E.S.; Cuijpers, P.; Van Ameringen, M.; Smits, J.A.; Powers, M.B. Psychological and pharmacological treatments for generalized anxiety disorder (GAD): A meta-analysis of randomized controlled trials. Cogn. Behav. Ther. 2020, 49, 1–21.
  • Laidsaar-Powell, R.C.; Bu, S.M.K. Partnering with and involving patients. In The Oxford Handbook of Health Communication, Behavior Change, and Treatment Adherence; Leslie, R., Martin, M., DiMatteo, R., Eds.; Oxford University Press: Oxford, UK, 2013; ISBN 9780199795833.
  • Charles, C.; Gafni, A.; Whelan, T. Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Soc. Sci. Med. 1997, 44, 681–692.
  • Force, G.T. Taking shared decision making more seriously. Lancet 2011, 377, 784.
  • Stacey, D.; Légaré, F.; Lewis, K.; Barry, M.J.; Bennett, C.L.; Eden, K.B.; Holmes-Rovner, M.; Llewellyn-Thomas, H.; Lyddiatt, A.; Thomson, R.; et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst. Rev. 2017, 4, CD001431.
  • Puschner, B.; Becker, T.; Mayer, B.; Jordan, H.; Maj, M.; Fiorillo, A.; Egerhazi, A.; Ivánka, T.; Munk-Jørgensen, P.; Bording, M.K.; et al. Clinical decision making and outcome in the routine care of people with severe mental illness across Europe (CEDAR). Epidemiol. Psychiatr. Sci. 2016, 25, 69–79.
  • Mundal, I.; Lara-Cabrera, M.L.; Betancort, M.; De las Cuevas, C. Exploring patterns in psychiatric outpatients’ preferences for involvement in decision-making: A latent class analysis approach. BMC Psychiatry 2021, 21, 133
  • Burns, L.; da Silva, A.L.; John, A. Shared decision-making preferences in mental health: Does age matter? A systematic review. J. Ment. Health 2020, 1–12.
  • Metz, M.J.; Veerbeek, M.A.; Elfeddali, I.; de Beurs, E.; van der Feltz-Cornelis, C.M.; Beekman, A.T.F. Shared decision making in mental health care; evaluation of the added value for patients and clinicians. Tijdschr. Psychiatry 2019, 61, 487–497.
  • Alguera-Lara, V.; Dowsey, M.M.; Ride, J.; Kinder, S.; Castle, D. Shared decision making in mental health: The importance for current clinical practice. Australas Psychiatry 2017, 25, 578–582.
  • De las Cuevas, C.; Rivero-Santana, A.; Perestelo-Pérez, L.; Pérez-Ramos, J.; Serrano-Aguilar, P. Attitudes toward concordance in psychiatry: A comparative, cross-sectional study of psychiatric patients and mental health professionals. BMC Psychiatry 2012, 12, 53.
  • van der Weijden, T.; Boivin, A.; Burgers, J.; Schünemann, H.J.; Elwyn, G. Clinical practice guidelines and patient decision aids. An inevitable relationship. J. Clin. Epidemiol. 2012, 65, 584–589.
  • Tlach, L.; Wüsten, C.; Daubmann, A.; Liebherz, S.; Härter, M.; Dirmaier, J. Information and decision-making needs among people with mental disorders: A systematic review of the literature. Health Expect 2015, 18, 1856–1872.
  • Llewellyn-Jones, S.; Jones, G.; Donnelly, P. Questions patients ask psychiatrists. Psychiatr. Bull. 2001, 25, 21–24.
  • Liebherz, S.; Härter, M.; Dirmaier, J.; Tlach, L. Information and Decision-Making Needs Among People with Anxiety Disorders: Results of an Online Survey. Patient Patient-Centered Outcomes Res. 2015, 8, 531–539.
  • Kivelitz, L.; Härter, M.; Mohr, J.; Melchior, H.; Goetzmann, L.; Warnke, M.H.; Kleinschmidt, S.; Dirmaier, J. Choosing the appropriate treatment setting: Which information and decision-making needs do adult inpatients with mental disorders have? A qualitative interview study. Patient Prefer. Adherence 2018, 12, 823–833.
  • World Health Organization. International Classification of Diseases, 11th Revision (ICD-11). World Health Organization. Available online: https://www.who.int/classifications/icd/en/ (accessed on 22 February 2021).
  • Michaelis, S.; Kriston, L.; Härter, M.; Watzke, B.; Schulz, H.; Melchior, H. Predicting the preferences for involvement in medical decision making among patients with mental disorders. PLoS ONE 2017, 12, e0182203.
  • Morán-Sánchez, I.; de los Ángeles Bernal-López, M.; Salmerón, D.; Pérez-Cárceles, M.D. Correlates of preferring a passive role in decision-making among patients with schizophrenia or bipolar disorder. Patient Educ. Couns. 2021, 104, 1125–1131.
  • Sangill, C.; Buus, N.; Hybholt, L.; Berring, L.L. Service user’s actual involvement in mental health research practices: A scoping review. Int. J. Ment. Health Nurs. 2019, 28, 798–815.