BACKGROUND: Shared decision making (SDM) is a process of active participation by clients with practitioners in weighing the risks and benefits of treatments. It has not been extended to decisions about making lifestyle modifications. OBJECTIVE: Describe how frequently health lifestyle behaviors are addressed in 15- to 20-minute medicine clinic visits with individuals who have psychiatric disabilities and how often SDM is used in reaching decisions. DESIGN: Content analysis of 98 audiotaped transcripts from practitioner and client medicine clinic visits. RESULTS: The most frequently discussed lifestyle behaviors discussed were sleep (89%) and diet (61%). SDM, defined as sharing information and options about behavior by either or both practitioner and client and affirmation of a decision by both, occurred 48 times (44%) when a problem existed. CONCLUSION: Discussion of lifestyle behaviors along with use of SDM in negotiating changes in behavior is feasible in a 15- to 20-minute visit.
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