Citation

Etingen B, Hill JN, Miller LJ, Schwartz A, Lavela SL, Jordan N. Mil. Med. 2019; 184(Suppl 1): 467-475.

Affiliation

Departments of Psychiatry & Behavioral Sciences and Preventive Medicine, Feinberg School of Medicine, Northwestern University, 446 East Ontario (#7-200), Chicago, IL.

Copyright

(Copyright © 2019, Association of Military Surgeons of the United States)

DOI

10.1093/milmed/usy407

PMID

30901448

Abstract

OBJECTIVE: To describe current practices used by Veterans Administration (VA) mental health (MH) providers involved in post-traumatic stress disorder (PTSD) treatment planning to support engagement of veterans with PTSD in shared decision-making (SDM).

METHODS: Semi-structured interviews with MH providers (n = 9) were conducted at 1 large VA, audio-recorded, and transcribed verbatim. Transcripts were analyzed deductively, guided by a published account of the integral SDM components for MH care.

RESULTS: While discussing forming a cohesive team with patients, providers noted the importance of establishing rapport and assessing treatment readiness. Providers' clinical knowledge/expertise, knowledge of the facility's treatment options, knowledge of how to navigate the VA MH care system, and patient factors (goals/preferences, factors influencing treatment engagement) were noted as important to consider when patients and providers exchange information. When negotiating the treatment plan, providers indicated that conversations should include treatment recommendations and concurrent opportunities for personalization. They also emphasized the importance of discussions to finalize a mutually agreeable patient- and provider-informed treatment plan and measure treatment impact.

CONCLUSION: These results offer a preliminary understanding of VA MH providers' facilitation of SDM for PTSD care.

FINDINGS may provide insights for MH providers who wish to engage patients with PTSD in SDM.

Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2019.

Language: en

Keywords

Mental Health Care; Patient-Centered Care; Post-Traumatic Stress Disorder; Shared Decision-Making; Veterans