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Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial

BACKGROUND: Subjective perception of coercion has gained attention as an important outcome. However, little is known about its relation to patients’ appraisal of the justification of coercive measures. The present study aims to analyze the relationship between patients’ appraisal of the justificatio...

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Autores principales: Wullschleger, Alexandre, Vandamme, Angelika, Mielau, Juliane, Heinz, Andreas, Bermpohl, Felix, Mahler, Lieselotte, Montag, Christiane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546675/
https://www.ncbi.nlm.nih.gov/pubmed/37784077
http://dx.doi.org/10.1186/s12888-023-05192-y
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author Wullschleger, Alexandre
Vandamme, Angelika
Mielau, Juliane
Heinz, Andreas
Bermpohl, Felix
Mahler, Lieselotte
Montag, Christiane
author_facet Wullschleger, Alexandre
Vandamme, Angelika
Mielau, Juliane
Heinz, Andreas
Bermpohl, Felix
Mahler, Lieselotte
Montag, Christiane
author_sort Wullschleger, Alexandre
collection PubMed
description BACKGROUND: Subjective perception of coercion has gained attention as an important outcome. However, little is known about its relation to patients’ appraisal of the justification of coercive measures. The present study aims to analyze the relationship between patients’ appraisal of the justification of coercive measures and their level of perceived coercion. METHODS: This study presents a secondary analysis of the results of a multi-center RCT conducted to evaluate the effects of post-coercion review. Patients who experienced at least one coercive measure during their hospital stay were included in the trial. Participants’ appraisal of the justification of coercive measures was categorized into patient-related and staff-related justifications. Subjective coercion was assessed using the Coercion Experience Scale (CES) and used as dependent variable in a multivariate regression model. RESULTS: 97 participants who completed the CES were included in the analysis. CES scores were significantly associated with the perception of the coercive measure as justified by staff-related factors (B = 0,540, p < 0,001), as well as with higher level of negative symptoms (B = 0,265, p = 0,011), and with mechanical restraint compared to seclusion (B=-0,343, p = 0,017). CONCLUSIONS: Patients’ perceptions of coercive measures as justified by staff-related factors such as arbitrariness or incompetence of staff are related to higher levels of perceived coercion. Multiprofessional efforts must be made to restrict the use of coercive measures and to ensure a transparent and sustainable decision-making process, particularly with patients showing high levels of negative symptoms. Such key elements should be part of all coercion reduction programs.
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spelling pubmed-105466752023-10-04 Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial Wullschleger, Alexandre Vandamme, Angelika Mielau, Juliane Heinz, Andreas Bermpohl, Felix Mahler, Lieselotte Montag, Christiane BMC Psychiatry Research BACKGROUND: Subjective perception of coercion has gained attention as an important outcome. However, little is known about its relation to patients’ appraisal of the justification of coercive measures. The present study aims to analyze the relationship between patients’ appraisal of the justification of coercive measures and their level of perceived coercion. METHODS: This study presents a secondary analysis of the results of a multi-center RCT conducted to evaluate the effects of post-coercion review. Patients who experienced at least one coercive measure during their hospital stay were included in the trial. Participants’ appraisal of the justification of coercive measures was categorized into patient-related and staff-related justifications. Subjective coercion was assessed using the Coercion Experience Scale (CES) and used as dependent variable in a multivariate regression model. RESULTS: 97 participants who completed the CES were included in the analysis. CES scores were significantly associated with the perception of the coercive measure as justified by staff-related factors (B = 0,540, p < 0,001), as well as with higher level of negative symptoms (B = 0,265, p = 0,011), and with mechanical restraint compared to seclusion (B=-0,343, p = 0,017). CONCLUSIONS: Patients’ perceptions of coercive measures as justified by staff-related factors such as arbitrariness or incompetence of staff are related to higher levels of perceived coercion. Multiprofessional efforts must be made to restrict the use of coercive measures and to ensure a transparent and sustainable decision-making process, particularly with patients showing high levels of negative symptoms. Such key elements should be part of all coercion reduction programs. BioMed Central 2023-10-02 /pmc/articles/PMC10546675/ /pubmed/37784077 http://dx.doi.org/10.1186/s12888-023-05192-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wullschleger, Alexandre
Vandamme, Angelika
Mielau, Juliane
Heinz, Andreas
Bermpohl, Felix
Mahler, Lieselotte
Montag, Christiane
Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title_full Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title_fullStr Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title_full_unstemmed Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title_short Relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
title_sort relationship between perceived coercion and perceived justification of coercive measures – secondary analysis of a randomized-controlled trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546675/
https://www.ncbi.nlm.nih.gov/pubmed/37784077
http://dx.doi.org/10.1186/s12888-023-05192-y
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