Faculty of Law (Lenagh-Glue, Dawson) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand; Southern District Health Board, Dunedin (Potiki, Casey); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom).
Psychiatr Serv. 2021 Feb 1;72(2):216-218. doi: 10.1176/appi.ps.202000080. Epub 2020 Oct 14.
Psychiatric advance directives (PADs) allow service users to participate in their own mental health care in the event that they have a future mental health crisis and are deemed incompetent to make decisions, but few patients complete these documents. This Open Forum reports on factors that have helped or hindered completion of PADs in New Zealand. Perceived barriers to completion include resource limitations, procedural issues, access and storage problems, and mistrust between clinicians and service users regarding implementation. Having management and nursing "champions" of the process and organizing outreach meetings for all interested parties appear to aid completion. Targeted education and training promote creation and use of PADs, address negative attitudes, and assist service users in creating these documents. Information technology support is vital to having PADs uploaded and accessed in medical records.
精神科预先指示（PAD）允许使用者在未来发生精神健康危机且被认为无法做出决策时参与自己的精神健康护理，但很少有患者完成这些文件。本《开放论坛》报告了在新西兰有助于或阻碍 PAD 完成的因素。被认为是阻碍完成的因素包括资源限制、程序问题、获取和存储问题，以及临床医生和服务使用者之间在实施方面的不信任。有管理和护理“倡导者”以及为所有相关方组织外展会议有助于完成 PAD。有针对性的教育和培训可以促进 PAD 的创建和使用，解决负面态度，并帮助服务使用者创建这些文件。信息技术支持对于将 PAD 上传并在医疗记录中访问至关重要。
