Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Ulla-Karin Schön, Stockholm University, Sweden
- Second opponent: Professor Marit Helene Hem, NTNU Social Research, Norway
- Third member and chair of the evaluation committee: Professor Reidar Tyssen, University of Oslo
Chair of the Defence
Professor Unn Kristin Hansen Haukvik, University of Oslo
Principal Supervisor
Professor Anne Signe Landheim, University of Inland Norway
Summary
Shared decision making (SDM) is a collaborative process between patients and health professionals, recommended at the policy level and advocated for ethical reasons, yet its implementation in mental health care, especially for patients with psychotic disorders, remains limited, highlighting a need for further knowledge.
The research questions of this thesis were: What experiences do patients with psychotic disorders and health professionals have with SDM, to what extent do patients report SDM, and what factors are associated with SDM? These questions were addressed through interviews with patients and health professionals, as well as with questionnaires.
Patients experienced that SDM was vital and stated that they were capable of this even in severe illness phases but that health professionals primarily made decisions for them. Health professionals found it challenging to share decisions when patients had limited understanding of their situation and described this as a barrier to SDM.
Both the patients and health professionals’ experienced that time to build trust is crucial for successful SDM. The patients conveyed that it was important to be listened to, taken seriously and to have good chemistry with health professionals, but that it was difficult to find the “right” one whom they got along with.
Patients reported a mean SDM score of 6.3 (scale from 0-9) and 14.1% scored the top score (highest response on all three questions). Increasing global satisfaction with services was associated with higher SDM.
The findings revealed that there is potential to improve SDM practices. The study also highlighted a need to place greater emphasis on how decision-making capacity may vary depending on both the nature of the decision and the patient’s condition. Health services should be organized in a way that provides health professionals with sufficient flexibility and time to build trusting relationships.
Additional information
Contact the research support staff.