精神卫生保健中预立声明的类型学。
A typology of advance statements in mental health care.
作者信息
Henderson Claire, Swanson Jeffrey W, Szmukler George, Thornicroft Graham, Zinkler Martin
机构信息
Department of Veterans Affairs Medical Center, Mental Illness Research, Education and Clinical Centers, Bronx, NY 10468, USA.
出版信息
Psychiatr Serv. 2008 Jan;59(1):63-71. doi: 10.1176/ps.2008.59.1.63.
Advance statements documenting mental health service consumers' preferences for treatment during a future mental health crisis or period of incapacity have gained currency in recent years in the United States and some European countries. Several kinds of advance statements have emerged -- some as legal instruments, others as treatment planning methods -- but no formal comparison has been made among them. This article reviews the literature in English and German to develop a comparative typology of advance statements: joint crisis plans, crisis cards, treatment plans, wellness recovery action plans, and psychiatric advance directives (with and without formal facilitation). The features that distinguish them are the extent to which they are legally binding, whether health care providers are involved in their production, and whether an independent facilitator assists in their production. The differing nature of advance statements is related to the diverse models of care upon which they are based and the legislative and service contexts in which they have been developed. However, there is recent convergence between the United Kingdom and the United States with respect to research interventions that facilitate the production of advance statements, as evidence emerges for the effectiveness of facilitated psychiatric advance directives and joint crisis plans. Different types of advance statements can coexist and in some cases may interact in complementary ways. However, the relationship of advance statements to involuntary treatment is more problematic, as is their effective implementation in many mental health service settings.
记录心理健康服务消费者在未来心理健康危机或无行为能力期间对治疗偏好的预先声明近年来在美国和一些欧洲国家开始流行。出现了几种类型的预先声明——有些是法律文书,有些是治疗规划方法——但尚未对它们进行正式比较。本文回顾了英文和德文文献,以建立预先声明的比较类型学:联合危机计划、危机卡、治疗计划、健康恢复行动计划以及精神科预先指令(有无正式协助)。区分它们的特征包括它们具有法律约束力的程度、医疗保健提供者是否参与其制定过程以及是否有独立协助者协助其制定。预先声明的不同性质与它们所基于的不同护理模式以及它们所产生的立法和服务背景有关。然而,随着有证据表明协助性精神科预先指令和联合危机计划的有效性,英国和美国在促进预先声明制定的研究干预措施方面最近出现了趋同。不同类型的预先声明可以共存,在某些情况下可能以互补的方式相互作用。然而,预先声明与非自愿治疗的关系更成问题,在许多心理健康服务环境中其有效实施也是如此。