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135 Can implementing DA-assisted decision support promote staff’s respectful attitude in psychiatric wards?
  1. Yuka Kudo1,2
  1. 1Department of Psychology and Language Sciences, University College London, London, the UK
  2. 2Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan


Introduction 160000 are still hospitalized for more than a year in psychiatric hospitals in Japan. One of the reasons is that many staff in psychiatric wards are too ready to believe it is safe and good to keep patients within their wards and never actively assist patient discharge. However, patients have their freedom restricted and can not live with dignity in wards. Therefore, we have developed a decision aid (DA) for patients to decide where they live so that staff can put themselves in the patient‘s shoes. This study examined whether staff can develop respectful attitudes by implementing DA- assisted decision support.

Methods Participants were patients who had been hospitalized for more than a year. Nurses, social workers, and psychiatrists served as decision supporters and conducted eight interviews using the DA, each 30 minutes. The content is designed to help supporters understand how patients have lived up until then and what kind of help they can get from their family.

Results In eight participants, three chose group homes, one 24-hour assisted home, and three hospitals.

Staff’s motivation to respect patient‘s wishes significantly increased in the Paired Samples t-test, which was 3.0 on a 5-point Likert scale before and 4.3 after (p=0.004). Also, we found in the questionnaire that it was because they could get to know the patients better that they felt stronger motivations to respect patients’ wishes. There were no significant differences in the short version of the Japanese Patient Dignity Scale,1 which measures staff’s attitude from patient’s perspectives (66.2 vs 71.4, p=0.162).

Discussion No significant difference might be due to various reasons, including patients justifying where they are.

Conclusion DA-assisted decision support can foster respectful attitudes among the staff in psychiatric hospitals.


  1. Mori T, Ota K. J Jpn Nurs Ethics. 2019;11(1):75–82.

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