Clinical Decision-Making During Psychiatric Ward Rounds

Introduction: For psychiatric in-patients, ward rounds are a prominent occasion for decision making. As previous findings on shared decision-making (SDM) patterns mostly derive from out-patients and one-to-one-consultations, it was our aim to investigate SDM during psychiatric ward rounds. Methods: We conducted a cross-sectional study and included n = 62 in-patients from seven different psychiatric wards. We collected data from the patient and the treating physician before and after ward rounds and recorded the interaction. Results: We identified two groups of patients regarding their attitude toward ward rounds (no expectations vs. clear agenda). The latter showed higher active engagement, expected more decisions to be made and discussed more topics. Generally, observer rated SDM was low, with vast differences between the doctors' and the patients' perception. Conclusion: Doctors and patients perceive ward rounds differently and there is a discrepancy between subjective and objective involvement. A rather paternalistic doctor-patient-relationship is observed, while patients feel sufficiently involved and vastly satisfied. The potential of ward rounds maximizes if patients have an agenda. Consequently, motivating patients to prepare themselves toward ward rounds should be part of the weekly routine, as well as improving patient participation and information procedures during ward rounds

Family medicine · Paternalism · Perception · Psychiatric ward · Psychiatry · Empathy and Medical Education · Medicine · Nursing · Patient Satisfaction in Healthcare · Patient-Provider Communication in Healthcare · Psychology

• Global Assessment of Functioning

  Open Access•Richard C W Hall•Psychosomatics•1995

  Incluir item

• Measuring patients’ desire for autonomy

  Open Access•Jack Ende, Lewis Kazis et al.•Journal of General Internal…•1989

  Incluir item

• Where Is the Evidence? A Systematic Review of Shared Decision Making and Patient Outcomes

  Open Access•L Aubree Shay, Jennifer Elston Lafata•Medical Decision Making•2015

  Incluir item

• The Option scale

  Open Access•Glyn Elwyn, Hayley Hutchings et al.•Health Expectations•2005

  Incluir item

• A Survey of Patients' Attitudes Towards Inpatient Psychiatric Ward Rounds

  Open Access•H D Foster, Wojciech Falkowski et al.•International Journal of Social…•1991

  Incluir item