Conocimientos y actitudes de médicos y enfermeras sobre las instrucciones previas

Flores, Rafael Toro; Mato, Agustín Silva; Rivero, Antonio Piga; Galán, María Teresa Alfonso

doi:10.1016/j.aprim.2013.03.003

Cited by 26 publications

(11 citation statements)

References 6 publications

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“…Some theoretical (Suess Schwend et al, 2016) and empirical research (Villagrán, Lara Ruiz‐Granados, & González‐Saiz, 2014), as well as a support guide for professionals and users of mental health services (Escuela Andaluza de Salud Pública, 2015), is available in relation to the Comprehensive Mental Health Plan of the Junta de Andalucía , but we found no evidence for its implementation. In addition, previous research in primary, specialist and palliative mental healthcare fields at the national level showed that providers were unaware of what an AHD entails or how to complete one (Aguilar‐Sánchez et al, 2018; Ameneiros, Carballada Rico, & Garrido Sanjuán, 2013; Champer Blasco, Caritg Monfort, & Marquet Palomer, 2010; Fajardo Contreras, Valverde Bolívar, Jiménez Rodríguez, Gómez Calero, & Huertas Hernández, 2015; Nebot, Ortega, Ortega, Mira, & Ortiz, 2010; Toro Flores, Silva Mato, Piga Rivero, & Alfonso Galán, 2013). Thus, considering the international relevance and use of AHDs in clinical practice, it would be useful to collect information about mental health providers’ general knowledge of AHDs and their attitudes towards them before implementing a multistage intervention process in the Spanish context.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes of Spanish mental health professionals towards advance healthcare directives

Juliá‐Sanchis

Cabañero‐Martínez

Martí

et al. 2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences. AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities. However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge? The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice. Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice? The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process. More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation. The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Abstract IntroductionAdvance healthcare directives (AHDs) in mental health offer important information regarding service users’ preferences. However, whether AHDs are truly understood by providers is questionable. AimTo survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. MethodWe cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. ResultsParticipants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. DiscussionLegal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practiceThe Spanish mental healthcare system requires legal and structural changes and must improve healthcare p...

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Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes of Spanish mental health professionals towards advance healthcare directives

Juliá‐Sanchis

Cabañero‐Martínez

Martí

et al. 2020

Psychiatric Ment Health Nurs

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“…Although various studies have shown a positive attitude of providers towards users’ AHD, this does not necessarily translate into providers’ adherence to users’ AHD (Coleman, ). Similarly, Spanish healthcare professionals in the specialist, primary and palliative fields show a positive attitude towards users’ AHD but are unaware of what an AHD comprises or how to complete one (Aguilar‐Sánchez et al, ; Champer Blasco, Caritg Monfort, & Marquet Palomer, ; Fajardo, Valverde Bolívar, Jiménez Rodríguez, Gómez Calero, & Huertas Hernández, ; Toro, Silva Mato, Piga Rivero, & Alfonso Galán, ). Furthermore, no study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs in the mental health field.…”

Section: Introductionmentioning

confidence: 99%

Advance healthcare directives in mental health: A qualitative analysis from a Spanish healthcare professional's viewpoint

Juliá‐Sanchis

García-Sanjuán

Martí

et al. 2019

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Advance care planning (ACP) in mental health is a useful tool to avoid human rights violations in mental health settings. However, ACP is not yet a reality in the Spanish context. The advance healthcare directive (AHD) is a document reflecting healthcare preferences, drafted within the framework of the ACP process, to be applied in situations in which an individual's legal capacity may be questionable. No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs in the mental health field. Considering their extensive use, further study of providers’ knowledge and attitudes is warranted. What does the paper add to existing knowledge? The study adds knowledge about the viewpoint of Spanish mental healthcare professionals towards the implementation of AHDs in their clinical practices. This study illuminates the prevailing paternalistic provider–user relationship as the main barrier surrounding AHD management in terms of decision‐making. Our findings support the need for broader awareness, staff training regarding the documentation, the conversation process and communication skills, and personalized assistance in the mental health services to implement AHDs in everyday practice. What are the implications for practice? Advance healthcare directives are a recovery tool that offers major information regarding mental health user preferences. Although they pose challenges for clinical practice, AHDs should be incorporated into interventional mental health care. Obtaining up‐to‐date perspectives held by mental healthcare professionals regarding AHDs allows the administration to determine the aspects requiring reinforcement. The implementation of AHDs in the Spanish mental health system requires macro‐ and micro‐changes, both ethically and structurally, so that mental healthcare professionals relinquish their paternalistic approach and embrace new ways of relating to users. AbstractIntroductionAn advance healthcare directive (AHD) is a written document that contains a patient‐in‐care's will and preferences concerning the treatment options available to them, should they lack decision‐making capacity. AHDs are completed within a broader framework known as advance care planning. No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs.AimTo explore the viewpoint of mental health professionals towards the implementation of AHDs in mental health.MethodA qualitative study was conducted using semi‐structured interviews that were thematically analysed.FindingsThree main themes were identified: care planning culture; barriers for the practical management of AHDs; and reasons to not honour patient‐in‐care AHDs.DiscussionProfessionals find it pragmatically difficult to stop applying traditional paternalistic practices. To implement AHDs, improving the knowledge and awareness of AHDs and management of non‐technical skills through training is required. Such training should include users and families and allow fo...

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“…In fact, several studies have pointed to a lack of knowledge regarding living wills among health professionals, as opposed to positive attitudes towards the document [16][17][18][19] , with a direct relationship between the level of knowledge and characteristics such as previous experience and academic education 18,19 . Likewise, procedures that do not comply with end-oflife legislation have already been associated with a lack of familiarity with these legal principles 20 .…”

Section: Discussion Of Resultsmentioning

confidence: 99%

Testamento vital: verificação e compartilhamento de informações em um hospital português

Ferreira

Nunes

2019

Rev. Bioét.

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Resumo Desde 2012, o testamento vital é direito legalmente protegido em Portugal. Este estudo, exploratório-descritivo, questionou médicos e enfermeiros de um hospital português sobre verificação e compartilhamento de informação relativa ao testamento vital. A maioria dos profissionais (57%) nunca verificou a existência do documento, embora considere ato importante (95%), compartilhe essa informação quando tem acesso a ela (82%) e julgue que o não compartilhamento tem implicações relevantes na prática de cuidados (86%). Os resultados mostram que verificar a existência de testamento vital não é, no hospital estudado, prática corrente. São necessários novos estudos que identifiquem as motivações subjacentes a esse comportamento e verifiquem se é comum em outras instituições de saúde, propondo medidas para promover prática profissional em consonância com o estabelecido pela lei.

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Conocimientos y actitudes de médicos y enfermeras sobre las instrucciones previas

Cited by 26 publications

References 6 publications

Knowledge and attitudes of Spanish mental health professionals towards advance healthcare directives

Knowledge and attitudes of Spanish mental health professionals towards advance healthcare directives

Advance healthcare directives in mental health: A qualitative analysis from a Spanish healthcare professional's viewpoint

Testamento vital: verificação e compartilhamento de informações em um hospital português

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