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Obstacles and possibilities for implementing SDM in Swedish mental health services: Supporting interactivity and participation
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0002-0790-9386
2017 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Obstacles and possibilities for implementing SDM in Swedish mental health services; Supporting interactivity and participation.

Main author: David Rosenberg, Associate Professor, Department of Social Work, Umeå University, Sweden

Co authors: Katarina Grim, Ulla-Karin Schön & Petra Svedberg

 

Introduction Despite Swedish health care policy, which emphasizes patient participation in the planning of health care services, few programs have concrete methods for achieving this goal. Previous studies have shown that staff attitudes and systems which maintain power differentials, create obstacles for achieving participation despite methods such as SDM.

The purpose of the study was to explore implementing SDM with an interactive digital decision tool, designed for users in community mental health services in Sweden. The tool was specifically developed, in collaborative research with users, to overcome disempowering experiences as they attempt to participate in treatment decisions.

Method

A process evaluation design (Moore et al. 2015) was utilized in order to investigate obstacles and possibilities for a structured intervention to facilitate participation in decision making. The design utilized in the study included collecting qualitative and quantitative data focused on three identified evaluation components; Context, Implementation and Mechanism of impact.

Results Staff considered that SDM was most appropriate for formal treatment planning and that the use of the digital decision tool, which enabled interactive communication between staff and users, did support the user to be prepared for decisions, as well as helping staff to stay focused on user wishes.

SDM was most often used voluntarily by each staff member, based on their experience and attitude, rather than a common practice for the service. Another barrier concerned capacity, with staff sometimes feeling they did not have formal power regarding treatment planning decisions, and expressing doubt as to the patient's willingness and ability to participate in decisions.

Discussion

The results suggest that contextual barriers to implementing shared decision making can be addressed by utilizing interactive decision tools which concretely structure the interaction between users and staff and are connected to formally required treatment planning processes that are essential for user participation.

Key words: Implementation, participation, Shared Decision making Preferred conference theme: 1. Recovery for different groups

Oral presentation

Place, publisher, year, edition, pages
2017.
National Category
Social Sciences Social Work
Identifiers
URN: urn:nbn:se:umu:diva-141420OAI: oai:DiVA.org:umu-141420DiVA, id: diva2:1154483
Conference
Refocus on Recovery 2017
Available from: 2017-11-02 Created: 2017-11-02 Last updated: 2018-06-09

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf