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Article
Author(s)
Daniela Blank, Ruth Weizel, Markus Witzmann
Full-Text PDF XML 966 Views
DOI:10.17265/2159-5542/2018.07.002
Affiliation(s)
Kbo-Isar-Amper Klinikum, Haar, Germany
Kliniken des Bezirks Oberbayern—Kommunalunternehmen, Munich, Germany
Kliniken des Bezirks Oberbayern—Kommunalunternehmen, Munich, Germany;
University of Applied Sciences, Munich, Germany
ABSTRACT
A joint crisis plan is a
written consensus-orientated agreement between mental health service users and
professionals. The instrument is used to regulate a potential future hospital
treatment. At the Clinics of Upper Bavaria (kbo-Kliniken des
Bezirks Oberbayern) representatives of the clinics, the organized relatives and
those affected developed the pilot project “Joint Crisis Plan” in a trialogical process. The pilot project was
evaluated between 2015 and 2017. The qualitative study
looked at the experiences with the implementation of the instrument medical
treatment agreement in different local settings. In doing so it considered the
complex effects of “advance directives” on various levels such as the
subjective importance and meaning as experienced by the patients, the effects
on face-to-face interactions between patients and the medical staff, and the
effects on institutional structures. And it considered the local influence—such as medical
cultures or economic and institutional conditions—on the implementation process and the use of this
instrument. The results showed that patients need numerous competences to
complete a joint crisis plan. Likewise the instrument affects self-efficacy and
self-images of the patients and the relation between the patients and the
clinical staff in a positive way. But if the joint crisis plan is
insufficiently implemented, the instrument generates rather a mortification of
the self.
KEYWORDS
psychiatric advance directives, joint crisis plan, concept of self, grounded theory
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