Shared decision making from the service users’ perspective: A narrative study from community mental health centers in northern Norway

This article aims to contribute to the understanding of shared decision making as an important aspect of user involvement in mental health care from the perspectives of service users. A thematic analysis of interviews with 25 individual service users in three different community mental health centers in Norway identified different understandings of shared decision making. Shared decision making was identified as essential in four contexts: 1) during admission, 2) in individualized treatment, 3) in different treatment contexts, and 4) in user-professional relationships. We consider shared decision making to be intertwined with treatment from the service user perspective.     

Developing a Strategy to Meaningfully Engage Stakeholders in Program/Policy Planning: A Guide for Human Services Managers and Practitioners

Stakeholder participation can be a valuable component of program/policy development in the human services. However, service users and other stakeholders often experience it as tokenistic and having little effect. Although management literature recommends stakeholder participation and social work ethics promote it, agency leaders and practitioners are given little guidance on how to design participation initiatives that integrate stakeholders' input into agency decision making. This article focuses on creating a strategy that can foster meaningful stakeholder participation. We outline 7 principles of meaningful participation and present a 12-step process for formulating a participation strategy that applies these principles.     

Learning in social networks: Selecting profitable choices among alternatives of uncertain profitability in various networks

Social capital theory assumes that information is valuable. However, only rarely is this value explicitly modeled, and there are few examples of empirical tests of mechanisms that connect social network structure to valuable information. We model an individual decision problem in which individuals make choices that yield uncertain outcomes. The individuals can learn about the profitability of options from their own choices and from the network. We generate computer-simulated data to derive hypotheses about the effect of network characteristics on making profitable choices. We conduct a laboratory experiment to empirically test these hypotheses and find that, at the individual level, degree centrality has a positive effect on making profitable choices whereas betweenness centrality has no effect. At the network level, density has a positive effect on making profitable choices, whereas centralization does not have an effect.     

Human resource management,employee engagement,and nonprofit hospital performance

Human resource management (HRM) has been shown to impact organizational performance, but more research is needed on particular human resource (HR) practices in nonprofits and their effect on performance. In this article, we explore one HRM practice argued to influence performance, employee engagement in decision‐making, examining whether involving staff at different levels of a nonprofit affects nonprofit organizational performance. Drawing on data from a 2011 study of nonprofit hospitals, we find employee engagement has a positive influence on managerial and stakeholder perceptions of organizational performance. Employee engagement in decision‐making is also related to objective nonprofit performance measures, although the effects are less consistent. We conclude by discussing the implications of these findings for nonprofit research and practice.     

Urban E-Government Initiatives and Environmental Decision Performance in Korea

Although e-government initiatives have been credited as enginesof government reform, empirical evidence is insufficient todetermine their effects on public sector performance. To explorethe impact of e-government on local governance, this articleexamines how e-government initiatives influence the perceivedperformance of environmental decision making in an urban contextand what organizational and contextual factors affect Web-aideddecision performance. Data were collected from the content analysisof city government Web sites and a nationwide survey of cityofficials in Korea. Findings from path analysis show that (1)information technology leadership of senior management and Website quality are key to decision intelligence, quality, andspeed and (2) e-government Web divide, a gap in the capabilityof city Web sites to support public service delivery and democraticinteraction, translates into disparities in environmental decisionperformance across cities. Additionally, environmental activismis a significant factor shaping the impact of e-government onenvironmental decision making. E-government initiatives contributeto local governance performance, but their impacts vary, dependingon Web site quality and the entrepreneurial leadership of publicmanagers.     

ACCOUNTING PRACTICES AND ORGANIZATIONAL DECISION MAKING

In this paper we argue for the importance of a sociologically informed study of organizational accounting practices. By making the nexus between accounting and decision making problematic, instead of given, we move issues of interpretation and hierarchical control to the center stage of understanding the social construction of accounting practices. We suggest that inductive case studies of the organizational setting is a promising methodological strategy for identifying how accounting operates as an organizational control system. We focus on debates and proceedings of the board of directors as an overlooked source of data on decision making and organizational practices. We show how accounting practices are part of the strategic control system that functions to interpret the environment and direct the adaptation of the organization in a manner particular to the substantive rationality of corporate decision makers. We illustrate these contentions with a case study of accounting practice changes over a six year period.     

BEHAVIORAL PATTERNS IN SOCIAL NETWORKS

In this article, we focus on the analysis of individual decision‐making for the formation of social networks, using experimentally generated data. We analyze the determinants of the individual demand for links under the assumption of agents' static expectations and identify patterns of behavior that correspond to three specific objectives: players propose links so as to maximize expected profits (myopic best response strategy); players attempt to establish the largest number of direct links (reciprocator strategy); and players maximize expected profits per direct link (opportunistic strategy). These strategies explain approximately 74% of the observed choices. We demonstrate that they are deliberately adopted and, by means of a finite mixture model, well identified and separated in our sample. (JEL C33, C35, C90, D85)     

Organizational ethics, decision making, undecidability

In this paper we develop a conceptualisation of organizational decision‐making as a practice that is, necessarily, ethical. The paper starts with a discussion of the notion of decision‐making as it relates to organizational rationality and the relationship between management and control. Drawing on Derrida's discussions of undecidability and responsibility, we suggest that as well as being able to consider organizational decision‐making as an instance of (albeit bounded) rationality or calculability, it can also be regarded as a process of choice amongst heterogenous possibilities. On that basis, we follow Derrida in arguing that for a decision to be considered an instance of responsible action it must be made with neither recourse to knowledge of its outcome nor to the application of pre‐ordained rules. Illustrating our argument with a discussion of Eichmann's ‘I was just following orders’ defence, we suggest that rules for ethical decision making, rather than ensuring ethical outcomes, can work to insulate organizations from moral responsibility. We conclude with a discussion of ethics and democracy in relation to responsible decision making in organizations.     

“Sensory Ordering” in Nurses' Clinical Decision‐Making: Making Visible Senses,Sensing, and “Sensory Work” in the Hospital

The objective of this article is to present a study on the constitutive role of senses in clinical decision‐making. The methodology is based on a series of focus groups with nurses in various hospital departments. Based on a narrative approach, our study examines “sensory work” in clinical decision‐making in order to reveal its specificity in the clinical work of nurses. Nurses shared stories—in focus groups—about the influence of senses in clinical decision‐making. The analysis of clinical narratives helped to identify various situations revealing the “sensory work” that underlines clinical decision‐making. We put the emphasis on the spectrum of sensory activities and the interactions occurring during a clinical decision‐making. One specific contribution of our study is to make visible the “sensory ordering” at work as constituted by interactions between nurses during a clinical assessment.     

Comparative influence of political, cost/benefit, and statistical information on administrative decision making.

The influence of three types of evaluation information was studied in simulated decisionmaking situations within a community mental health center setting. Twelve administrators reviewed one of two decision problems (direct services or indirect services funding) and were then presented political, cost/benefit and statistical information. After each presentation, the administrators rated the importance of each type of information for decision making. Only the cost/benefit data were rated as significantly influencing their decisions. The influence of each type was not dependent upon the decision problem, nor to length of time in administrative positions. The results were interpreted in terms of “who says what, how, and to whom. ” If evaluators desire a greater impact on the decision making behavior of community health administrators, they should consider employing a pay off-based evaluation strategy and providing cost/benefit information.     

Resilience and Decision‐Making Strategies as Predictors of Career Decision Difficulties

The purpose of this study was to examine resilience and decision‐making strategies as predictors of difficulties experienced during the career decision‐making process. College students (N = 364) responded to measures of resilience, career decision‐making strategies, and career decision difficulties. Results indicated that resilience and decision‐making strategies accounted for 46% of the variance in career decision difficulties. Resilience had a greater influence on problems encountered during decision making than on problems encountered at the outset of the process. Different decision‐making strategies appeared to be related to difficulties encountered at different stages of the decision‐making process. For example, aspiration for an ideal occupation was positively associated only with lack of readiness. Procrastination was the only strategy related to all three decision difficulties: lack of readiness, lack of information, and inconsistent information. The results indicated the importance of decreasing procrastination at all stages of decision making and the need to promote resilience to deal with decision difficulties.     

Core-periphery or decentralized? Topological shifts of specialized information on Twitter

In this paper we investigate shifts in Twitter network topology resulting from the type of information being shared. We identified communities matching areas of agricultural expertise and measured the core-periphery centralization of network formations resulting from users sharing generic versus specialized information. We found that centralization increases when specialized information is shared and that the network adopts decentralized formations as conversations become more generic. The results are consistent with classical diffusion models positing that specialized information comes with greater centralization, but they also show that users favor decentralized formations, which can foster community cohesion, when spreading specialized information is secondary.     

Task Interdependence as a Moderator of the Relation Between Group Control and Performance

Data were collected from the managers of 77groups in a large service organization and a largemanufacturing organization. The results revealed thatthe relation between group control over decision making and group performance became more positive withincreased levels of task interdependence. The mainimplication of the findings is that increasing groupcontrol over decisions may result in high performance only for groups that are highly taskinterdependent. The performance of groups that are lowin task interdependence may suffer when provided withgroup-level control of decisions.     

Predictors of Marital Satisfaction Among Korean Immigrant Spouses in the United States

ABSTRACT

This study investigated marital satisfaction among Korean immigrant spouses. Level of acculturation, the number of years of U.S. residence, status inconsistency, annual income, educational level, decision making, division of household tasks, and communication problems were hypothesized to be predictors of marital satisfaction. A snowball sampling strategy yielded 304 respondents. Results showed that level of acculturation was significantly associated with marital satisfaction for Korean immigrant husbands, but not for Korean immigrant wives. Marital decision making was significantly related to marital satisfaction for Korean immigrant wives but not for Korean immigrant husbands. Both acculturation and marital decision making accounted for only 3% of the variance in marital satisfaction. For both spouses, conjugal communication problems were the best predictor of marital satisfaction (16% and 37% of variance explained for husbands and wives, respectively).     

Implications of behavioural economics for financial literacy and public policy

This paper summarizes and highlights different methodological approaches to behavioural economics in the context of the conventional economic wisdom and the implications of these different methodological approaches for financial literacy, related institutional change, and public policy. Conventional economics predicts no substantive improvement from improvements to financial literacy. The errors and biases approach to behavioural economics suggests limited improvements to decision making from financial education as errors and biases are largely hardwired in the brain. Government and expert intervention affecting individual choice behaviour is recommended. The evidence suggests that the bounded rationality approach to behavioural economics, with its focus on smart decision makers and the importance institutional and environment constraints on decision making, is the most promising lense through which to analyse financial decision making. From this perspective, financial decision making can be improved by providing decision makers with better quality information presented in a non-complex fashion, an institutional environment conducive to good decisions, an incentive structure that internalize externalities involved in financial decision making, and financial education that will facilitate making the best use of the information at hand within a specific decision-making environment.     

Ownership patterns and centralization: A China and U.S. comparison

The paper examines the relationships between ownership and decision-making patterns in small business organizations in China and the United States. We also consider organizational size and the culture-free/culture-bound argument. The U.S. data (a sample of 540 enterprises) were collected by questionnaire in 1988; the Chinese data (a sample of 53 enterprises) by a converted and translated questionnaire based on the U.S. version and interviews in 1989. Findings indicate that the Chinese organizations with various forms of ownerships are more centralized than their U.S. counterparts, which is consistent with the culture-bound perspective. On the other side of the coin, findings suggest that in both China and United States, organizational centralization of decision making decreases with increasing size, although to different degree, which appears to support the culture-free argument.     

VOTING IN FIRMS: THE ROLE OF AGENDA CONTROL, SIZE AND VOTER HOMOGENEITY

Voting is a common feature of most firms. Unrestricted voting, however, can lead to unstable decision making. We find that firms make tradeoffs among collective decision making, production scale, firm structure, and voter characteristics that are consistent with efforts to economize on the costs of voting. Firm responses include agenda control, restrictions to obtain a homogeneous voting population, and limits on firm size. We consider three long-surviving producer cooperatives, representing extreme cases of collective decision making, and find that their organization is sensitive to the costs of voting and to the employment of mechanisms to constrain those costs.     

On the same page: The value of paid and volunteer leaders sharing mental models in churches

We examine the idea that mental models shared among paid and volunteer leaders are associated with improved financial performance in nonprofit organizations. Our empirical analysis of thirty‐seven churches yields evidence that organizations are more effective if paid and volunteer leaders have a shared task mental model—that is, if they report similar conceptualizations of organizational goals and decision‐making processes. These findings suggest that the extent of leaders' agreement on organizational goals and the processes of how decisions are made matter for organizational performance. We argue that it is as important to ensure that everyone is on the same page with regard to goals and how decisions are made as it is to have the “right” goals or right decision processes in place. Implications for practice and future research on shared mental models are discussed.     

The Decision-Making Context and Its Impact on Local Human Service Nonprofits

One significant factor affecting an organization's functioning is the decisions made by other organizations that are important to it. We examine decision-making in three local human service delivery nonprofits, focusing on the level (local versus national) of the actors making decisions as well as the degree of horizontal or vertical coordination among decision makers. The findings show that the decision-making context affects nonprofit structure and operations and suggest that providers may have to make significant trade-offs as they seek to restructure in response to policy changes such as devolution.     

Assessment in a specialist referred family centre: outcomes for children

Relatively little is known about the outcomes of assessment as an information gathering mechanism as well as a therapeutic encounter in which service users explore and share their problems. Assessment in child welfare is now a highly topical issue given the new assessment framework recently introduced to England and which is currently a matter of consultation in Wales. In contributing to a long running debate over ‘what works’ in child protection assessment and intervention, a United Kingdom national voluntary child care agency commissioned the authors to undertake a three year outcomes study of a child and family assessment service provided by their specialist referred family centre in South Wales. The paper sets out selected findings that reveal an assessment regimen which encouraged partnership, enjoyed a comparatively high level of engagement particularly from male parents/carers, and was perceived by adult users as positive. It promoted clear decision making about the placement of children. Also, children involved in these assessments appeared to be exposed to low risk of re‐abuse compared to other relevant studies. Copyright © 2001 John Wiley & Sons, Ltd.