TY - JOUR
T1 - Clinical Decision-Making During Psychiatric Ward Rounds
AU - Holzhüter, Fabian
AU - Schuster, Florian
AU - Heres, Stephan
AU - Hamann, Johannes
N1 - Publisher Copyright:
© Copyright © 2021 Holzhüter, Schuster, Heres and Hamann.
PY - 2021/9/13
Y1 - 2021/9/13
N2 - 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.
AB - 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.
KW - patient participation
KW - patient-doctor communication
KW - psychiatric in-patient
KW - shared decision making
KW - ward round communication
UR - http://www.scopus.com/inward/record.url?scp=85115884084&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2021.721699
DO - 10.3389/fpsyt.2021.721699
M3 - Article
AN - SCOPUS:85115884084
SN - 1664-0640
VL - 12
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 721699
ER -