The influence of an interactive educational approach on advance care planning counseling in individuals with psychiatric disorders.

Abstract

Background: In Taiwan, psychiatric patients often face premature judgments regarding cognitive impairment, emotional instability, communication barriers, or issues related to guardianship rights due to their psychiatric diagnosis. This leads to a reduction in their autonomy in healthcare decision-making. Advocacy for and experiential understanding of Advance Care Planning (ACP) among individuals with psychiatric disorders are significantly lacking. This research explores the influence of an interactive educational approach on the ACP process for psychiatric patients and whether this approach can enhance their comprehension, attitudes, and intentions regarding Advance Decisions (AD).

Methods: To accommodate potential variances and ensure robustness in our findings, we ultimately elected to recruit 90 participants. Using a computer-generated random number generator, we conducted a randomized trial, assigning 45 individuals to the control group and an equal number to the intervention group. The control group continued with the routine self-care educational curriculum, while the intervention group, in addition to the standard curriculum, participated in bi-weekly intervention sessions for three months. This resulted in six group health education sessions, each lasting one hour. To evaluate participants' knowledge, attitudes, and intent to sign regarding ACP, the effects of group, time, and their interactions were assessed using Generalized Estimating Equations.

Results: Both groups were homogeneous at baseline. Post-intervention, Knowledge improved by 3.31 points (p < 0.001) and Attitude by 4.91 points (p < 0.001). However, the increase in Intent to Sign (0.73 points, p = 0.222) was not statistically significant. The overarching findings indicate that the application of an interactive educational model significantly enhances psychiatric patients' knowledge and attitudes toward ACP, although it does not substantially impact their intention to sign.

Conclusions: Interactive education effectively enhances psychiatric patients' knowledge and attitudes toward ACP but does not significantly influence their intent to sign AD. We advocate for their empowerment in ACP discussions. This study highlights the feasibility of integrating ACP promotion into routine psychiatric care.