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爱尔兰精神科工作人员对预先医疗指示的态度和知识

Attitudes and knowledge relating to advance healthcare directives among psychiatry staff in Ireland.

作者信息

Redahan Maria, Rock Catherine, Grudzien Michal, Kelly Brendan D

机构信息

Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin 24, Tallaght, D24 NR0A, Ireland.

出版信息

Ir J Med Sci. 2025 Mar 27. doi: 10.1007/s11845-025-03943-2.

Abstract

BACKGROUND

Advance healthcare directives are the subject of increased interest in psychiatry. A new legislative framework for advance healthcare directives came into effect in Ireland in 2023 in the Assisted Decision Making (Capacity) Act, 2015.

AIM

To investigate levels of knowledge about, and attitudes towards, advance healthcare directives among multidisciplinary psychiatry inpatient staff in Ireland one year after commencement of the new legislation.

METHODS

A survey was completed among psychiatry inpatient staff (n = 51) in Tallaght University Hospital, Dublin, Ireland between June and August 2024.

RESULTS

Majorities of psychiatry inpatient staff have heard of advance healthcare directives (84.3%), think they are a good idea (90.2%), and recommend involving medical staff (84.3%) and/or family and friends (68.6%) in writing them. There are high levels of confidence that staff would respect and be able to access advance healthcare directives when needed, but divided opinions on whether patients understand enough about advance healthcare directives. A majority of staff members (74.5%) would prefer an advance care plan that was not legally binding but still included the patient's will and preferences.

CONCLUSIONS

Psychiatry inpatient staff are largely supportive of advance healthcare directives but identify needs for more patient education and an explicit option for non-binding, rather than binding, advance healthcare directives.

摘要

背景

预先医疗指示在精神病学领域越来越受到关注。2023年,爱尔兰一项关于预先医疗指示的新立法框架在《2015年辅助决策(能力)法案》中生效。

目的

调查新立法实施一年后,爱尔兰多学科精神病住院部工作人员对预先医疗指示的了解程度和态度。

方法

2024年6月至8月期间,对爱尔兰都柏林塔拉赫特大学医院的精神病住院部工作人员(n = 51)进行了一项调查。

结果

大多数精神病住院部工作人员听说过预先医疗指示(84.3%),认为这是个好主意(90.2%),并建议在撰写时让医务人员(84.3%)和/或家人朋友(68.6%)参与。工作人员对在需要时尊重并能够获取预先医疗指示有很高的信心,但对于患者是否对预先医疗指示有足够了解存在分歧。大多数工作人员(74.5%)更喜欢一份不具有法律约束力但仍包含患者意愿和偏好的预先护理计划。

结论

精神病住院部工作人员在很大程度上支持预先医疗指示,但认为需要加强对患者的教育,并明确提供非约束性而非约束性预先医疗指示的选项。

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