Advance healthcare directives in mental health: A qualitative analysis from a Spanish healthcare professional's viewpoint

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Title: Advance healthcare directives in mental health: A qualitative analysis from a Spanish healthcare professional's viewpoint
Authors: Juliá-Sanchis, Rocío | Garcia-Sanjuan, Sofia | Zaragoza Martí, María Francisca | Cabañero-Martínez, María José
Research Group/s: Person-centred Care and Health Outcomes Innovation / Atención centrada en la persona e innovación en resultados de salud (PCC-HOI) | Clima y Ordenación del Territorio | Calidad de Vida, Bienestar Psicológico y Salud | Agua y Territorio | Recursos Hídricos y Desarrollo Sostenible
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería | Universidad de Alicante. Departamento de Estudios Jurídicos del Estado
Keywords: Advance directives | Living wills | Mental health | Mental illness | Nursing | Professionals
Knowledge Area: Enfermería | Derecho Constitucional
Issue Date: Sep-2019
Publisher: John Wiley & Sons
Citation: Journal of Psychiatric and Mental Health Nursing. 2019, 26(7-8): 223-232. doi:10.1111/jpm.12539
Abstract: Introduction: An advance healthcare directive (AHD) is a written document that contains a patient‐in‐care's will and preferences concerning the treatment options available to them, should they lack decision‐making capacity. AHDs are completed within a broader framework known as advance care planning. No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs. Aim: To explore the viewpoint of mental health professionals towards the implementation of AHDs in mental health. Method: A qualitative study was conducted using semi‐structured interviews that were thematically analysed. Findings: Three main themes were identified: care planning culture; barriers for the practical management of AHDs; and reasons to not honour patient‐in‐care AHDs. Discussion: Professionals find it pragmatically difficult to stop applying traditional paternalistic practices. To implement AHDs, improving the knowledge and awareness of AHDs and management of non‐technical skills through training is required. Such training should include users and families and allow for compliance with United Nations requirements. Implications for practice: Advance healthcare directives offer important information regarding user preferences, although they pose challenges for practices. Acquiring an up‐to‐date perspective on the attitudes of professionals towards AHDs allows organizations to attend to particular aspects that require reinforcement. Wider awareness, staff training and new ways of relating to users are necessary to implement AHDs in Spanish context. Relevance statement: A better understanding of the attitudes of Spanish mental health professionals towards AHDs was achieved. Despite the implementation of AHDs being an important and potentially beneficial initiative, mental health professionals find many pragmatic issues that need addressing before AHDs become a reality in their clinical practice. Wider awareness, staff training, personalized assistance and new ways of relating to users are required to implement AHDs in everyday practice.
Sponsor: Office of the Vice President of Research and Knowledge Transfer for the promotion of R&D in the University of Alicante 2017 Programme, Grant/Award Number: GRE17-05.
ISSN: 1351-0126 (Print) | 1365-2850 (Online)
DOI: 10.1111/jpm.12539
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2019 The Authors. Journal of Psychiatric and Mental Health Nursing Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Peer Review: si
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Appears in Collections:INV - PCC-HOI - Artículos de Revistas
INV - Recursos Hídricos y Desarrollo Sostenible - Artículos de Revistas
INV - CyOT - Artículos de Revistas
INV - CV, BP Y S - Artículos de Revistas
INV - Agua y Territorio - Artículos de Revistas

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