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Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions
BACKGROUND: There is a lack of evidence to underpin decisions on what constitutes the most effective and least restrictive form of coercive intervention when responding to violent behavior. Therefore we compared ratings of effectiveness and subjective distress by 125 inpatients across four types of...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412723/ https://www.ncbi.nlm.nih.gov/pubmed/22647058 http://dx.doi.org/10.1186/1471-244X-12-54 |
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author | Georgieva, Irina Mulder, Cornelis L Whittington, Richard |
author_facet | Georgieva, Irina Mulder, Cornelis L Whittington, Richard |
author_sort | Georgieva, Irina |
collection | PubMed |
description | BACKGROUND: There is a lack of evidence to underpin decisions on what constitutes the most effective and least restrictive form of coercive intervention when responding to violent behavior. Therefore we compared ratings of effectiveness and subjective distress by 125 inpatients across four types of coercive interventions. METHODS: Effectiveness was assessed through ratings of patient behavior immediately after exposure to a coercive measure and 24 h later. Subjective distress was examined using the Coercion Experience Scale at debriefing. Regression analyses were performed to compare these outcome variables across the four types of coercive interventions. RESULTS: Using univariate statistics, no significant differences in effectiveness and subjective distress were found between the groups, except that patients who were involuntarily medicated experienced significant less isolation during the measure than patients who underwent combined measures. However, when controlling for the effect of demographic and clinical characteristics, significant differences on subjective distress between the groups emerged: involuntary medication was experienced as the least distressing overall and least humiliating, caused less physical adverse effects and less sense of isolation. Combined coercive interventions, regardless of the type, caused significantly more physical adverse effects and feelings of isolation than individual interventions. CONCLUSIONS: In the absence of information on individual patient preferences, involuntary medication may be more justified than seclusion and mechanical restraint as a coercive intervention. Use of multiple interventions requires significant justification given their association with significant distress. |
format | Online Article Text |
id | pubmed-3412723 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34127232012-08-07 Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions Georgieva, Irina Mulder, Cornelis L Whittington, Richard BMC Psychiatry Research Article BACKGROUND: There is a lack of evidence to underpin decisions on what constitutes the most effective and least restrictive form of coercive intervention when responding to violent behavior. Therefore we compared ratings of effectiveness and subjective distress by 125 inpatients across four types of coercive interventions. METHODS: Effectiveness was assessed through ratings of patient behavior immediately after exposure to a coercive measure and 24 h later. Subjective distress was examined using the Coercion Experience Scale at debriefing. Regression analyses were performed to compare these outcome variables across the four types of coercive interventions. RESULTS: Using univariate statistics, no significant differences in effectiveness and subjective distress were found between the groups, except that patients who were involuntarily medicated experienced significant less isolation during the measure than patients who underwent combined measures. However, when controlling for the effect of demographic and clinical characteristics, significant differences on subjective distress between the groups emerged: involuntary medication was experienced as the least distressing overall and least humiliating, caused less physical adverse effects and less sense of isolation. Combined coercive interventions, regardless of the type, caused significantly more physical adverse effects and feelings of isolation than individual interventions. CONCLUSIONS: In the absence of information on individual patient preferences, involuntary medication may be more justified than seclusion and mechanical restraint as a coercive intervention. Use of multiple interventions requires significant justification given their association with significant distress. BioMed Central 2012-05-30 /pmc/articles/PMC3412723/ /pubmed/22647058 http://dx.doi.org/10.1186/1471-244X-12-54 Text en Copyright ©2012 Georgieva et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Georgieva, Irina Mulder, Cornelis L Whittington, Richard Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title | Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title_full | Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title_fullStr | Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title_full_unstemmed | Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title_short | Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
title_sort | evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412723/ https://www.ncbi.nlm.nih.gov/pubmed/22647058 http://dx.doi.org/10.1186/1471-244X-12-54 |
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