Department of Psychology, Gyeongsang National University, South Korea.
Int J Psychiatry Med. 2013;45(3):279-98. doi: 10.2190/PM.45.3.g.
This study examined whether coercive measures or perceived coercion experienced by mentally disabled patients in the hospitalization process could be justified under paternalism. To find out whether coercion can be justified by paternalism, a year of follow-up research was conducted to examine the impact of coercive measures and perceived coercion experienced during hospitalization on the patients' therapeutic benefit.
A 6-month period and a 1-year period of follow-up research was conducted with 266 patients to assess whether the coercion they experienced during hospitalization (coercive measures and perceived coercion) had an effect on changing the patients' mental symptoms and insight.
The results showed a decrease in both mental symptoms and insight over time. However, it was found that neither coercive measures nor perceived coercion had a significant effect on the change of mental symptoms and that, thus, coercion had little contribution to the declining of symptoms. Coercive measures had no effect on the change of insight but perceived coercion was shown to have a positive effect on a change in insight. Patient insight was shown to improve with increased perceived coercion.
Paternalism provides a partial explanation to serve as a basis for justifying perceived coercion. Limitations and suggestions for further study are discussed.
本研究探讨在住院过程中，针对精神障碍患者实施的强制性措施或其感受到的强制性是否可以从家长主义的角度得到证明。为了确定强制性措施是否可以通过家长主义得到证明，我们进行了为期一年的随访研究，以检验住院期间的强制性措施和感受到的强制性对患者治疗效果的影响。
对 266 名患者进行了为期 6 个月和 1 年的随访研究，以评估他们在住院期间所经历的强制性措施（强制性措施和感受到的强制性）是否会影响其精神症状和洞察力的改变。
结果显示，精神症状和洞察力随时间推移而逐渐下降。然而，我们发现强制性措施或感受到的强制性对精神症状的变化均无显著影响，因此，强制性措施对症状的减轻贡献不大。强制性措施对洞察力的变化没有影响，但感受到的强制性对洞察力的变化具有积极影响。随着感受到的强制性的增加，患者的洞察力得到改善。
家长主义提供了部分解释，可作为证明感受到的强制性的依据。讨论了研究的局限性和进一步研究的建议。
