Nicaise P, Soto V E, Dubois V, Lorant V
Institute of Health and Society (IRSS), Université catholique de Louvain, B1.30.15, Clos Chapelle-Aux-Champs, 30, 1200, Brussels, Belgium,
Adm Policy Ment Health. 2015 Jul;42(4):384-93. doi: 10.1007/s10488-014-0580-2.
Although clinical and organisational benefits have been expected from Psychiatric Advance Directives (PADs), their take-up rates remain low and their evaluation disappointing. The endorsement of PADs by stakeholders is decisive for their use and understanding stakeholders' preferences for implementation is crucial. A Multinomial Discrete Choice analysis was carried out of options for designing, completing, and honouring PADs, with a view to enhancing user autonomy, therapeutic alliance, care coordination, and feasibility. Although autonomy underlies the whole process, the criteria determining options varied with the stage of the intervention. These criteria should be taken into account in future PAD intervention and evaluation processes.
尽管人们期望精神科预先指示(PADs)能带来临床和组织效益,但其采用率仍然很低,评估结果也令人失望。利益相关者对PADs的认可对其使用至关重要,了解利益相关者对实施的偏好也至关重要。为了增强用户自主性、治疗联盟、护理协调和可行性,对设计、填写和遵守PADs的选项进行了多项离散选择分析。尽管自主性是整个过程的基础,但决定选项的标准会随着干预阶段而变化。在未来的PAD干预和评估过程中应考虑这些标准。