TY - JOUR
T1 - Exploring the Decision-Making Process for Electroconvulsive Therapy in Patients With Major Depressive Disorder and Their Relatives After Treatment
AU - Rovers, Jordy
AU - Schönberger, Lieke
AU - Loef, Dore
AU - van Eijndhoven, Philip
AU - Verwijk, Esmée
AU - Somers, Metten
AU - Dols, Annemiek
AU - Tendolkar, Indira
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc.
PY - 2025/9/1
Y1 - 2025/9/1
N2 - OBJECTIVES: Shared decision making is used for reaching medical decisions, also in the management of major depressive disorder (MDD). Electroconvulsive therapy (ECT) is an effective treatment option for patients with severe MDD. However, the decision-making process, specifically the exchange of evidence-based information, for ECT may be hampered by the controversy and stigma surrounding ECT. We aim to explore the experiences of the decision-making process of patients and their relatives who have chosen to receive ECT in order to guide optimization of shared decision making in ECT.METHODS: Semistructured interviews were conducted with MDD patients and their relatives who had voluntarily received ECT between 2018-2023 at the Radboud University Medical Center, the Netherlands. The interviews were analyzed by thematic analysis.RESULTS: Meaning saturation occurred after 16 interviews. The following 3 major themes emerged: 1) information is key, 2) empowering the decision, and 3) lived experiences with ECT. Participants emphasized the importance of accessible information presented in a calm and stepwise manner. They also identified gaps in desired information, particularly regarding memory loss and difficulty in retaining the given information. Factors empowering the decision included support from family, healthcare professionals, peers, and desperation, while negative factors included stigma, negative images, lack of support, and fear. Lived experiences with ECT might influence a future decision. Positive experiences were improved attitudes, treatment effects, and empathic and involved professionals, while negative aspects included cognitive side effects and lack of follow-up.CONCLUSIONS: This study offers insights into factors influencing the decision-making process in patients with MDD that received ECT. It shows possibilities for improving the decision-making process in clinical practice.
AB - OBJECTIVES: Shared decision making is used for reaching medical decisions, also in the management of major depressive disorder (MDD). Electroconvulsive therapy (ECT) is an effective treatment option for patients with severe MDD. However, the decision-making process, specifically the exchange of evidence-based information, for ECT may be hampered by the controversy and stigma surrounding ECT. We aim to explore the experiences of the decision-making process of patients and their relatives who have chosen to receive ECT in order to guide optimization of shared decision making in ECT.METHODS: Semistructured interviews were conducted with MDD patients and their relatives who had voluntarily received ECT between 2018-2023 at the Radboud University Medical Center, the Netherlands. The interviews were analyzed by thematic analysis.RESULTS: Meaning saturation occurred after 16 interviews. The following 3 major themes emerged: 1) information is key, 2) empowering the decision, and 3) lived experiences with ECT. Participants emphasized the importance of accessible information presented in a calm and stepwise manner. They also identified gaps in desired information, particularly regarding memory loss and difficulty in retaining the given information. Factors empowering the decision included support from family, healthcare professionals, peers, and desperation, while negative factors included stigma, negative images, lack of support, and fear. Lived experiences with ECT might influence a future decision. Positive experiences were improved attitudes, treatment effects, and empathic and involved professionals, while negative aspects included cognitive side effects and lack of follow-up.CONCLUSIONS: This study offers insights into factors influencing the decision-making process in patients with MDD that received ECT. It shows possibilities for improving the decision-making process in clinical practice.
KW - ECT
KW - experiences
KW - major depressive disorder
KW - qualitative research
KW - shared decision making
UR - https://www.scopus.com/pages/publications/105001056543
U2 - 10.1097/YCT.0000000000001106
DO - 10.1097/YCT.0000000000001106
M3 - Article
C2 - 39998858
SN - 1095-0680
VL - 41
SP - 197
EP - 205
JO - The journal of ECT
JF - The journal of ECT
IS - 3
ER -