Informed
Consumers Decision-Making in Using or Declining Psychiatric Advance Directives
Principal
Investigator: Michaela
Amering, MD (University of Vienna). Co-PI: Peter Stastny,
MD (Bronx Psychiatric Center),
Kim Hopper, Ph. D.
PROJECT
GOALS
This exploratory study
will use grounded theory methods to generate conceptual tools and interpretive
frameworks for more extensive study of the psychiatric advance directives
(PAD) decision-making process. The specific aim is to delve intensively into
the deliberations of subjects actively considering executing a PAD. Subjects
will be New York State consumers of public mental health services, who have
undergone a brief training course in the use of health proxies and PADs.
RESEARCH ACTIVITIES AND RESULTS
In late 2001, the
P.I. conducted participant-observation in a number of training sessions run
by the Resource Center under contract with New York State. These venues were
used to recruit subjects for subsequent interviews and focus groups. A total
of 20 subjects were intensively interviewed; half decided to complete a PAD,
the other half were undecided to date. Two focus groups were also conducted.
All interviews and focus groups were taped and have been transcribed (or,
in a few cases, extensively paraphrased). The study team reviewed initial
transcripts and notes, drafted a provisional coding scheme, revised the scheme
after testing, and completed coding of the entire textual archive. Analysis
began in June 2002.
POLICY IMPLICATIONS
Because it focuses
on the deliberation process of persons considering PADs, it should shed light
on both training issues (what to cover, how, what sorts of follow-up may be
indicated), and on the potential of PADS as negotiating tools in structuring
the terms and conditions of the therapeutic relationship – or that portion
of which falls within institutional domains. It also promises to illuminate
dimensions of empowerment and coercion in the decision-making activities of
those considering PADs.
PLANS
Draft publication
is currently being written and two presentations will be made to research
conferences (by P.I. Michaela Amering) .
Inclusion
of Gender and Minority Groups
|
|
American
Indian or Alaskan Native |
Asian
or Pacific Islander |
Black,
not of Hispanic Origin |
Hispanic
|
White,
not of Hispanic Origin |
Total
|
| Female
|
0
|
0 |
4 |
3 |
9
|
16 |
|
Male
|
0
|
1
|
7
|
2 |
7
|
17
|
|
Unknown
|
|
|
|
|
|
|
|
TOTAL
|
|
1
|
11 |
5
|
16 |
33
|
Entered: July
17, 2003
