eprintid: 10112092
rev_number: 24
eprint_status: archive
userid: 608
dir: disk0/10/11/20/92
datestamp: 2023-07-28 11:22:01
lastmod: 2023-07-28 11:22:01
status_changed: 2023-07-28 11:22:01
type: thesis
metadata_visibility: show
creators_name: Liverpool, Shaun
title: An affective appraisal approach to shared decision-making: Theory, evidence and interventions for parents and carers of children with mental problems
ispublished: unpub
divisions: UCL
divisions: A01
divisions: B02
divisions: C07
divisions: D05
note: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
abstract: Background: Policy guidelines recommend service user involvement in care and treatment decision-making as a person-centred approach to improving health outcomes. However, most shared decision-making (SDM) models are perceived as a rational process. There is a need for research exploring the role of emotions in children and young people’s mental health (CYPMH) decisions. This thesis aimed to develop an affective appraisal approach to SDM based on theory and evidence and to develop and pilot an intervention to support parents/carers and promote SDM. Methods: Several study designs were adopted. (1) Qualitative synthesis to understand the emotional experiences of parents. (2) Logistic regression analysis of parental help-seeking. (3) Multilevel modelling to investigate SDM in CYPMH services. (4) Interviews and focus groups with parents/carers and healthcare professionals to further explore the effect of emotions on SDM. (5) Scoping review to identify and examine existing decision support interventions. (6) Feasibility and acceptability randomised controlled trial of a novel intervention. Findings: (1) Seven categories describing parents’ emotions emerged as influencing factors to CYPMH care and treatment decisions. (2) A negative association between parental worry and help-seeking was found. (3) Almost 70% of parents reported experiencing SDM in CYPMH, and findings justified a multilevel approach to studying SDM. (4) A framework for an affective appraisal model of SDM emerged. (5) Twenty-three existing interventions were identified, incorporating an average of 4.57 elements of SDM. Time, accessibility and appropriateness emerged as factors influencing usage and implementation. (6) Although, the novel intervention (Power Up for Parents) was found to be acceptable, some changes to the recruitment strategy may be needed before upgrading to a full trial. Conclusion: This thesis provides a theoretical understanding that parents are ‘expected to, but not always able to’ be actively involved in care and treatment decisions. Integrating this concept in CYPMH may help to inform policy and practice for the implementation of SDM. These findings also provide insight for researchers to establish a foundation for developing future interventions using the affective appraisal approach.
date: 2020-10-28
date_type: published
oa_status: green
full_text_type: other
thesis_class: doctoral_open
thesis_award: Ph.D
language: eng
thesis_view: UCL_Thesis
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1821342
lyricists_name: Liverpool, Shaun
lyricists_id: SSLIV90
actors_name: Liverpool, Shaun
actors_id: SSLIV90
actors_role: owner
full_text_status: public
pages: 517
event_title: University College London
institution: UCL (University College London)
department: Division of Psychology and Language Sciences
thesis_type: Doctoral
citation:        Liverpool, Shaun;      (2020)    An affective appraisal approach to shared decision-making: Theory, evidence and interventions for parents and carers of children with mental problems.                   Doctoral thesis  (Ph.D), UCL (University College London).     Green open access   
 
document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10112092/1/Liverpool_10112092_Thesis.pdf