Redahan Maria, Rock Catherine, Grudzien Michal, Kelly Brendan
Department of Psychiatry, Trinity College Dublin Faculty of Health Sciences, Dublin, Ireland.
Ir J Psychol Med. 2025 Jun 25:1-7. doi: 10.1017/ipm.2025.26.
To investigate levels of knowledge and attitudes towards advance healthcare directives among inpatient psychiatry service users in Ireland.
A survey was completed among adult inpatient psychiatry service users ( = 47) in Tallaght University Hospital, Dublin.
Just over one in ten (11%) inpatient psychiatry service users had heard of advance healthcare directives. None had created an advance healthcare directive, but over a quarter (25.5%) had written down or verbally told someone what they would like to happen when they became unwell. When asked 'if you were supported by your healthcare provider to make an advance healthcare directive, would you like to make one?', over two thirds responded either 'definitely yes' (34%) or 'probably yes' (34%). On multi-variable testing, future willingness to make an advance healthcare directive was significantly associated with younger age but not with ethnicity, gender, education, employment status, or prior knowledge of advance healthcare directives. All respondents would involve someone else in making an advance healthcare directive. There was high confidence that healthcare practitioners would respect an advance healthcare directive (87%).
There are high levels of interest in advance healthcare directives, but low levels of knowledge and use among inpatient psychiatry service users in Ireland. Our findings indicate a need for educational initiatives and resources to increase awareness. Such efforts could usefully focus especially on appropriate use of advance healthcare directives in psychiatric care and seek to bridge the gaps between evidence of benefit, legislative reform, and their use in mental healthcare.
调查爱尔兰住院精神科服务使用者对预先医疗指示的认知水平和态度。
对都柏林塔拉赫特大学医院的成年住院精神科服务使用者(n = 47)进行了一项调查。
略多于十分之一(11%)的住院精神科服务使用者听说过预先医疗指示。没有人制定过预先医疗指示,但超过四分之一(25.5%)的人已经写下或口头告诉过别人自己生病时希望发生的事情。当被问及“如果你的医疗服务提供者支持你制定预先医疗指示,你愿意制定一份吗?”时,超过三分之二的人回答“肯定愿意”(34%)或“可能愿意”(34%)。在多变量测试中,未来制定预先医疗指示的意愿与较年轻的年龄显著相关,但与种族、性别、教育程度、就业状况或预先医疗指示的先前知识无关。所有受访者都会让其他人参与制定预先医疗指示。人们高度相信医疗从业者会尊重预先医疗指示(87%)。
爱尔兰住院精神科服务使用者对预先医疗指示有很高的兴趣,但认知水平和使用率较低。我们的研究结果表明需要开展教育倡议和提供资源以提高认识。这些努力尤其可以有效地集中在精神科护理中预先医疗指示的适当使用上,并试图弥合受益证据、立法改革及其在精神卫生保健中的使用之间的差距。