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Participation in medical decision-making across Europe: An international longitudinal multicenter study

Published online by Cambridge University Press:  23 March 2020

A. Bär Deucher ,
MP Hengartner ,
W. Kawohl ,
J. Konrad ,
B. Puschner ,
E. Clarke ,
M. Slade ,
V. Del Vecchio ,
G. Sampogna  and
A. Égerházi
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A. Bär Deucher*
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930Zurich8021, Switzerland
MP Hengartner
Affiliation:
Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Pfingstweidstrasse 96, PO Box 707Zurich8037, Switzerland
W. Kawohl
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930Zurich8021, Switzerland
J. Konrad
Affiliation:
Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2 Günzburg89312, Germany
B. Puschner
Affiliation:
Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2 Günzburg89312, Germany
E. Clarke
Affiliation:
Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
M. Slade
Affiliation:
Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
V. Del Vecchio
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, Naples80138, Italy
G. Sampogna
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, Naples80138, Italy
A. Égerházi
Affiliation:
Department of Psychiatry, Medical and Health Science Centre, University of Debrecen 98, Nagyerdei krt, Debrecen, 4012, Hungary
Á. Süveges
Affiliation:
Department of Psychiatry, Medical and Health Science Centre, University of Debrecen 98, Nagyerdei krt, Debrecen, 4012, Hungary
M. Krogsgaard Bording
Affiliation:
Aalborg University Hospital, Psychiatry, Mølleparkvej 10 Aalborg9000, Denmark
P. Munk-Jørgensen
Affiliation:
Department M, Aarhus University Hospital, Skovagervej 2, Risskov8240, Denmark
W. Rössler
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930Zurich8021, Switzerland
*
* Corresponding author. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland. Tel.: +41 44 744 47 85; fax: +41 44 744 47 88. E-mail address:arlette.baer@puk.zh.ch(A. Baär Deucher).
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Abstract

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.

Keywords

Clinical decision-makingPatient participationMulticenter studySevere mental illness
Type
Original article
Information
European Psychiatry , Volume 35 , May 2016 , pp. 39 - 46
Copyright
Copyright © European Psychiatry 2016

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Footnotes

1

Both authors contributed equally.

References

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