Unit for Social & Community Psychiatry, Barts and the London School of Medicine, Queen Mary University of London, Newham Centre for Mental Health, Cherry Tree Way, Glen Road, London, E13 8SP, UK.
Soc Psychiatry Psychiatr Epidemiol. 2012 Jul;47(7):1169-79. doi: 10.1007/s00127-011-0427-z. Epub 2011 Aug 24.
To explore involuntary patients' retrospective views on why their hospitalisation was right or wrong.
Involuntary patients were recruited from 22 hospitals in England and interviewed in-depth. The study drew on grounded theory and thematic analysis.
Most of the patients felt mentally unwell before admission and out of control during their treatment. Despite these common experiences, three groups of patients with distinct views on their involuntary hospitalisation were identified: those who believed that it was right, those who thought it was wrong and those with ambivalent views. Those with retrospectively positive views believed that hospitalisation ensured that they received treatment, averted further harm and offered them the opportunity to recover in a safe place. They felt that coercion was necessary, as they could not recognise that they needed help when acutely unwell. Those who believed that involuntary admission was wrong thought that their problems could have been managed through less coercive interventions, and experienced hospitalisation as an unjust infringement of their autonomy, posing a permanent threat to their independence. Patients with ambivalent views believed that they needed acute treatment and that hospitalisation averted further harm. Nonetheless, they thought that their problems might have been managed through less coercive community interventions or a shorter voluntary hospitalisation.
The study illustrates why some patients view their involuntary hospitalisation positively, whereas others believe it was wrong. This knowledge could inform the development of interventions to improve patients' views and treatment experiences.
探讨非自愿住院患者对其住院治疗正确或错误的回顾性看法。
从英格兰的 22 家医院招募非自愿住院患者进行深入访谈。本研究采用扎根理论和主题分析。
大多数患者在入院前都感到精神不适，在治疗过程中失去控制。尽管有这些共同的经历，但还是确定了三组对非自愿住院治疗有不同看法的患者：认为正确的、认为错误的和持矛盾看法的。那些对住院治疗持回顾性积极看法的患者认为，住院治疗确保了他们得到治疗，避免了进一步的伤害，并为他们提供了在安全的地方康复的机会。他们认为强制是必要的，因为他们在急性疾病时无法认识到自己需要帮助。那些认为非自愿入院错误的患者认为，他们的问题本可以通过非强制性的干预措施来解决，并且他们将住院治疗视为对其自主权的不公正侵犯，对其独立性构成了永久性威胁。持矛盾看法的患者认为他们需要急性治疗，住院治疗避免了进一步的伤害。尽管如此，他们认为他们的问题可能可以通过非强制性的社区干预或较短的自愿住院来解决。
该研究说明了为什么一些患者对其非自愿住院治疗持积极态度，而另一些患者则认为这是错误的。这些知识可以为改善患者的看法和治疗体验的干预措施的制定提供信息。
