To Make Another Goal or to Dream a Different Dream-A Mixed Method Study of Experiences of People Using Mental Health Advance Care Planning.
Vrinda Edan, Lisa Brophy, Bridget Hamilton
PMID 40757749WHAT IT FOUND
Mental health advance statements were often not found or discussed, but when nurses or advocates engaged with them, consumers described value.
Survey respondents reported 91% of items were followed; interviews showed varied experiences.
Key findings
01Among 57 survey respondents with an advance statement who had been admitted, 39% reported difficulty locating the document, and nurses were the staff most likely to discuss it (44.6%).
02Survey respondents reported that 91% of items in their advance statements were followed, 7% were not followed, and 2% were followed in part.
03Interview participants reported that advance statements were often not mentioned unless they raised them, and that a nurse advocate helped one participant discuss and negotiate preferences with the psychiatrist.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The survey analysed only 59 people with an advance statement, and the 27 people without one were excluded, so it cannot describe why consumers do not write statements. Only 4 interviews were done, and the authors do not claim they are representative. No demographic data were collected for interview participants, except that 3 used metropolitan services and 1 used a rural service. Recruitment was through advocacy bodies, peer networks and social media, so participants may be more advocacy-aware than the wider mental health consumer population. The study reports experiences and suggestions, not tested effects of advance statements or nurse advocacy. The author is a consumer academic, and interviews were analysed with supervisors; this positionality shaped interpretation.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that advance statements reliably change treatment decisions. The survey reported 91% of items followed, but only 59 respondents with an advance statement were analysed, and interviews showed statements were often not found or discussed. This is a description of experiences, not evidence of effectiveness.