Les directives anticipées en psychiatrie : revue de la littérature qualitative, état des lieux et perspectives

Maître, Elsa; Debien, Christophe; Nicaise, Pablo; Wyngaerden, François; Galudec, Mickaël Le; Genest, P; Ducrocq, François; Delamillieure, Pascal; Lavoisy, B.; Walter, Michel; Dubois, Vincent; Vaïva, Guillaume

doi:10.1016/j.encep.2012.10.012

Cited by 18 publications

(12 citation statements)

References 31 publications

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“…Anticipated directives are a good way to respect the person's choices in moments of decompensation. (24) As these authors define it, "Anticipated directives are a set of instructions, written in advance by a conscious person, in case they are unable to express their will". (24) The user is able to appoint a person of trust, who will be able to make decisions for them, express their preference, or, on the contrary, their refusal to take certain medications.…”

Section: How Could Care Schemes Be Adapted While Respecting the Empow...mentioning

confidence: 99%

“…(24) As these authors define it, "Anticipated directives are a set of instructions, written in advance by a conscious person, in case they are unable to express their will". (24) The user is able to appoint a person of trust, who will be able to make decisions for them, express their preference, or, on the contrary, their refusal to take certain medications. In France, this type of document still has very little legal value, although such directives make an actor of the suffering person.…”

Section: How Could Care Schemes Be Adapted While Respecting the Empow...mentioning

confidence: 99%

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Empowerment: a step towards the (r)evolution of recovery

Dupuis¹,

Castillo²

2022

J Rec Mental Health

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We are witnessing a revolution in the field of mental health in France. The notions of recovery, empowerment and social inclusion drive us to transform our care practices. New care and support schemes are being devised throughout the entire French territory. In France, however, the concrete application of empowerment in the field is rather slow, as the notion’s theoretical complexity and promotion are significant moot points. In this article, we aim to address these French difficulties in order to suggest means of implementing empowerment-centered support methodologies. We demonstrate how this notion is correlated with other theoretical movements and how it overlaps with new notions with the aim of leading an ethical reflection. We also illustrate our reflection with clinical observations from the Un chez soi d’abord (equivalent of the US Housing First scheme) scheme. Keywords: Empowerment, Recovery, Housing First, Support, Ethics, Humanism

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Section: How Could Care Schemes Be Adapted While Respecting the Empow...mentioning

confidence: 99%

Section: How Could Care Schemes Be Adapted While Respecting the Empow...mentioning

confidence: 99%

Empowerment: a step towards the (r)evolution of recovery

Dupuis¹,

Castillo²

2022

J Rec Mental Health

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“…Les directives anticipées sont un ensemble d'instructions écrites, rédigées à l'avance par une personne consciente, pour le cas où elle serait dans l'incapacité d'exprimer sa volonté. Elles peuvent être utilisées en psychiatrie pour la prise en charge de patients présentant une schizophrénie [35]. Leur objectif est de permettre au patient d'exprimer par avance ses volontés concernant la prise en charge future (personne de confiance, traitement médicamenteux, etc.).…”

Section: Entretien Développé Avec Les Investigateursunclassified

Schizophrénie et consentement à la recherche biomédicale

et al. 2015

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“…Specific forms of PADs are described such as crisis cards, treatment plans, Ulysses Directives, Joint Crisis Plan (JCP), facilitated psychiatric advance directives, care plan, advance care plan, advance decision-making, and the Wellness Recovery Action Plan (WRAP) [25–31]. All these forms of PAD have treatment preferences in common but differ in legal framework, the presence or not of a facilitator, the sharing conditions, and their content, in particular their integration in a self-management plan, and the designation of a health care agent to act on behalf of the person should he or she be deemed mentally incapable in the future [32–36]. PADs are considered to be a complex intervention, with a) several interacting components including the document itself, support by the facilitator, professional and family context, and b) several relevant levels of implementation including completion of the document, content of the document, access to directives by stakeholders and compliance with directives [37].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric advance directives for people living with schizophrenia, bipolar I disorders, or schizoaffective disorders: Study protocol for a randomized controlled trial – DAiP study

Tinland¹,

Leclerc²,

Loubière³

et al. 2019

BMC Psychiatry

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BackgroundCompulsory admission to psychiatric hospital is rising despite serious ethical concerns. Among measures to reduce compulsory admissions, Psychiatric Advance Directives (PAD) are the most promising, with intensive PAD (i.e. facilitated and shared) being the most effective. The aim of the study is to experiment Psychiatric Advance Directives in France.MethodsA multicentre randomized controlled trial and qualitative approach conducted from January 2019 to January 2021 with intent-to-treat analysis.SettingSeven hospitals in three French cities: Lyon, Marseille, and Paris. Research assistants meet each participant at baseline, 6 months and 12 months after inclusion for face-to-face interviews.Participants400 persons with a DSM-5 diagnosis of bipolar I disorder (BP1), schizophrenia (SCZ), or schizoaffective disorders (SCZaff), compulsorily admitted to hospital within the last 12 months, with capacity to consent (MacCAT-CR), over 18 years old, and able to understand French.InterventionsThe experimental group (PAD) (expected n = 200) is invited to fill in a document describing their crisis plan and their wishes in case of loss of mental capacity. Participants meet a facilitator, who is a peer support worker specially trained to help them. They are invited to nominate a healthcare agent, and to share the document with them, as well as with their psychiatrist. The Usual Care (UC) group (expected n = 200) receives routine care.Main outcomes and measuresThe primary outcome is the rate of compulsory admissions to hospital during the 12-month follow-up. Secondary outcomes include quality of life (S-QoL18), satisfaction (CSQ8), therapeutic alliance (4-PAS), mental health symptoms (MCSI), awareness of disorders (SUMD), severity of disease (ICG), empowerment (ES), recovery (RAS), and overall costs.DiscussionImplication of peer support workers in PAD, potential barriers of supported-decision making, methodological issues of evaluating complex interventions, evidence-based policy making, and the importance of qualitative evaluation in the context of constraint are discussed.Trial registrationClinicalTrials.gov identifier: NCT03630822. Registered 14th August 2018.

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Les directives anticipées en psychiatrie : revue de la littérature qualitative, état des lieux et perspectives

Cited by 18 publications

References 31 publications

Empowerment: a step towards the (r)evolution of recovery

Empowerment: a step towards the (r)evolution of recovery

Schizophrénie et consentement à la recherche biomédicale

Psychiatric advance directives for people living with schizophrenia, bipolar I disorders, or schizoaffective disorders: Study protocol for a randomized controlled trial – DAiP study

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