Coercion and patient satisfaction on psychiatric acute wards

Iversen, Knut Ivar; Høyer, Georg; Sexton, Harold

doi:10.1016/j.ijlp.2007.09.001

Cited by 52 publications

(70 citation statements)

References 20 publications

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“…A strength of this study is that we examined variables and outcomes that have not been included in previous studies that measured accumulated coercive events (7,14). A limitation of this study is that our sample may be biased because we had a low completion rate for some measures and we could not include individuals with first episode psychosis.…”

Section: Discussionmentioning

confidence: 99%

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Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Shannon¹,

Roche²,

Madigan³

et al. 2015

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(2015). Quality of life and functioning one year after experiencing accumulated coercive events during psychiatric admission. Psychiatric Services, 66, 883-7. Corresponding AuthorStephen Shannon stshanno@gmail.com Abstract ObjectivesTo determine: the number of accumulated coercive events during admission and associations, functioning and quality of life one year after discharge and associations and whether accumulated coercive events were related to these outcomes. MethodsA prospective cohort study at three community services and an independent hospital was undertaken in Ireland. The accumulated coercive events score was based on legal status, perceived coercion and episodes of physical restraint, seclusion or forced medication. Results 110(68%) of all 162 participants experienced at least one coercive event. Lower functioning predicted more coercive events. One year after discharge, subjective quality of life was 63% of the highest possible score, objective quality of life improved for 15% and functioning improved for 70% of individuals. Accumulated coercive events did not predict these outcomes. ConclusionsCoercive events are common during psychiatric admission and appear unrelated to functioning and quality of life one year after discharge.

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Section: Discussionmentioning

confidence: 99%

“…The accumulated coercive events algorithm was originally used in a Norwegian psychiatric population to calculate all coercive events for each service user (14). The …”

Section: Methodsmentioning

confidence: 99%

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Shannon¹,

Roche²,

Madigan³

et al. 2015

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“…Embora o encaminhamento obrigatório esteja fortemente associado à percepção de coerção (Iversen et al, 2007), esta informação aponta para um dado inusitado de que pessoas em atendimento não obrigatório podem sentir-se de alguma forma obrigadas a buscar tratamento, mesmo que não tenham sido formalmente encaminhadas para psicoterapia. Estudos sugerem que nem sempre o uso da coerção é evidente no atendimento obrigatório e que não se pode equipará-lo a uma falta de vontade para o tratamento.…”

Section: Discussionunclassified

Fatores associados à formação da aliança terapêutica na psicoterapia obrigatória

Becker¹,

Benetti

2014

Estud. psicol. (Natal)

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ResumoO objetivo deste estudo foi identifi car de que forma se estabelece a aliança terapêutica (AT) em pacientes encaminhados de forma obrigatória para a psicoterapia, em comparação aos pacientes que buscam atendimento psicoterapêutico voluntariamente, verifi cando-se também as características das representações de objeto, mecanismos de defesa, percepção de coerção, e gravidade dos sintomas. Participaram da pesquisa 51 sujeitos, sendo 15 casos em psicoterapia obrigatória e 36 casos em tratamento voluntário. Ambos os grupos foram selecionados em uma instituição pública de saúde que oferece psicoterapia para funcionários públicos municipais. Os resultados apontaram que apesar dos pacientes obrigatórios apresentarem sintomas mais graves, foi possível o estabelecimento da AT. Além disso, o status de paciente obrigatório não infl uenciou o estabelecimento da AT e sim a percepção de coerção na procura de atendimento.Palavras-chave: aliança terapêutica; psicoterapia; psicologia. AbstractFactors associated with the formation of the therapeutic alliance in mandatory psychotherapy. Th e aim of this study was to identify how the therapeutic alliance (TA) is established in patients referred for mandatory psychotherapy compared to patients who seek psychotherapy voluntarily. It was also verifi ed o the characteristics of object representations, defense mechanisms; perception of coercion and severity of symptoms. Participants were 51 subjects, divided into a psychotherapy mandatory group (N = 15), which was compared with a group of patients in voluntary treatment (N = 36). Both groups were selected from a public health institution that provides psychotherapy for municipal employees, both voluntary and mandatory. Th e results showed that although mandatory patients showed more symptoms, it was possible to establish the TA. Moreover, the mandatory status did not infl uence the establishment of TA, but the perception of coercion when seeking treatment.Keywords: therapeutic alliance; psychotherapy; psychology. ResumenFactores asociados con la formación de la alianza terapéutica en la psicoterapia obligatoria. El objetivo de este estudio fue identifi car la forma de establecer la alianza terapéutica (AT) en pacientes referenciados para la psicoterapia obligatoria en comparación con los pacientes que voluntariamente buscan atención psicoterapéutica, además de verifi car las características de representaciones de objetos, mecanismos de defensa , la coerción percibida, y la gravedad de los síntomas. Participaron en el estudio 51 sujetos, 15 casos de psicoterapia obligatoria y 36 en el tratamiento voluntario. Ambos grupos fueron reclutados de una institución de salud pública que proporciona la psicoterapia para los empleados municipales. Los resultados mostraron que a pesar de los pacientes obligatorios tenían síntomas más graves, fue posible establecer la AT. Además, la situación de paciente obligatorio no infl uyó en la creación de la AT y sí, la percepción de coerción en la búsqueda de atención.Palabras clave: alianza terapéutica;...

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“…An accumulated coercive events algorithm was developed by Iversen et al (2007) and it reflects a total level of coercion experienced by an individual during their admission and is based on their legal status, level of perceived coercion and the number of episodes of physical coercion (restraint, seclusion or medication without consent). The algorithm was adapted for use in an Irish setting, the main difference being that the original scale had a section for involuntarily treatment in the community and this does not apply to an Irish setting.…”

Section: Instrumentsmentioning

confidence: 99%

Service users’ perspective of their admission: a report of study findings

O’Donoghue

Roche²,

Lyne

et al. 2016

Ir. j. psychol. Med.

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Objectives. The 'Service Users' Perspective of their Admission' study examined voluntarily and involuntarily admitted services users' perception of coercion during the admission process and whether this was associated with factors such as the therapeutic alliance, satisfaction with services, functioning and quality of life. This report aims to collate the findings of the study.Methods. The study was undertaken across three community mental health services in Ireland. Participants were interviewed before discharge and at 1 year using the MacArthur Admission Experience. Caregivers of participants were interviewed about their perception of coercion during the admission.Results. A total of 161 service users were interviewed and of those admitted involuntarily, 42% experienced at least one form of physical coercion. Service users admitted involuntarily reported higher levels of perceived coercion and less procedural justice than those admitted voluntarily. A total of 22% of voluntarily admitted service users reported levels of perceived coercion comparable with involuntarily admitted service users and this was associated with treatment in a secure ward or being brought to hospital initially under mental health legislation. In comparison with the service user, caregivers tended to underestimate the level of perceived coercion. The level of procedural justice was moderately associated with the therapeutic relationship and satisfaction with services. After 1 year, 70% experienced an improvement in functioning and this was not associated with the accumulated level of coercive events, when controlled for confounders.Conclusions. This study has provided valuable insights into the perceptions of coercion and can help inform future interventional studies aimed at reducing coercion in mental health services.

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Coercion and patient satisfaction on psychiatric acute wards

Cited by 52 publications

References 20 publications

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Fatores associados à formação da aliança terapêutica na psicoterapia obrigatória

Service users’ perspective of their admission: a report of study findings

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