Thesis: User participation and shared decision-making in adolescents’ inpatient mental healthcare
Bjønness has explored user participation and shared decision-making for adolescents in inpatient mental health services. The thesis presents insight into user participation, demonstrates prerequisites for adolescents to participate in treatment decisions, and moves the knowledge field of user participation further. Output from this thesis can be used to raise the quality of healthcare services and make them better adapted to adolescents' needs. Bjønness defended his thesis on the 22nd of April 2022.
The thesis addresses patient involvement as a quality indicator, legal right, and ethical imperative, combined with an increased demand for acute mental healthcare services for adolescents. Which experiences with shared decision-making exist within this context, and how could the healthcare services be adapted to meet the challenges? The thesis is based on three sub-studies, each dealing with different perspectives on user participation and shared decision-making in treating severe mental illness among adolescents. Healthcare professionals, adolescents, and parents were interviewed individually and in focus groups. The thesis also contains a literature review and meta-synthesis of the three sub-studies.
The findings demonstrate how healthcare services facilitating user participation increase adolescents’ ownership of their own treatment and can reduce an asymmetric power balance between patients and healthcare professionals. Moreover, it has the potential to prevent readmission to inpatient units and reduce the use of coercion. Adapted information and support for adolescents and parents strengthen shared decision-making and adherence to treatment decisions.
Current practice with an emphasis on diagnosis rather than function in treatment was found to be a barrier to shared decision-making. The relationship between adolescents and healthcare professionals is fundamental to establishing a treatment collaboration that embraces user participation. The thesis underlines the need for coordination of services, awareness of attitudes among healthcare professionals, and routines allowing a person-centered approach. Based on the results, Bjønness argues that shared decision-making should be considered a process through the entire course of treatment.
Stig Bjønness (48) is a psychiatric nurse and cognitive therapist and holds a master’s degree in health sciences from UiS. After his Ph.D., Stig works as an associate professor at the Department of Public Health.
Main supervisor:
Professor Marianne Storm, University of Stavanger, Department of Public Health.
Co-supervisors:
Jan Olav Johannessen, Stavanger University Hospital, Department of Psychiatry/ University of Stavanger, Department of Public Health.
Trond Grønnestad, University of Stavanger, Department of Public Health.
