Valenti Emanuele, Banks Ciara, Calcedo-Barba Alfredo, Bensimon Cécile M, Hoffmann Karin-Maria, Pelto-Piri Veikko, Jurin Tanja, Mendoza Octavio Márquez, Mundt Adrian P, Rugkåsa Jorun, Tubini Jacopo, Priebe Stefan
Department of Medical Specialties, Psychology and Pedagogy Applied, School of Biomedical Sciences, Universidad Europea de Madrid, Campus Villaviciosa de Odón, Madrid, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2015 Aug;50(8):1297-308. doi: 10.1007/s00127-015-1032-3. Epub 2015 Feb 27.
Whilst formal coercion in psychiatry is regulated by legislation, other interventions that are often referred to as informal coercion are less regulated. It remains unclear to what extent these interventions are, and how they are used, in mental healthcare. This paper aims to identify the attitudes and experiences of mental health professionals towards the use of informal coercion across countries with differing sociocultural contexts.
Focus groups with mental health professionals were conducted in ten countries with different sociocultural contexts (Canada, Chile, Croatia, Germany, Italy, Mexico, Norway, Spain, Sweden, United Kingdom).
Five common themes were identified: (a) a belief that informal coercion is effective; (b) an often uncomfortable feeling using it; (c) an explicit as well as (d) implicit dissonance between attitudes and practice-with wider use of informal coercion than is thought right in theory; (e) a link to principles of paternalism and responsibility versus respect for the patient's autonomy.
A disapproval of informal coercion in theory is often overridden in practice. This dissonance occurs across different sociocultural contexts, tends to make professionals feel uneasy, and requires more debate and guidance.
虽然精神病学中的正式强制手段受到法律规范，但其他常被称为非正式强制的干预措施则较少受到规范。在精神卫生保健中，这些干预措施的程度以及使用方式仍不明确。本文旨在确定不同社会文化背景国家的精神卫生专业人员对使用非正式强制手段的态度和经验。
在十个具有不同社会文化背景的国家（加拿大、智利、克罗地亚、德国、意大利、墨西哥、挪威、西班牙、瑞典、英国）与精神卫生专业人员进行了焦点小组讨论。
确定了五个共同主题：（a）认为非正式强制手段有效；（b）使用时常常感到不舒服；（c）态度与实践之间存在明确以及（d）隐含的不一致——非正式强制手段的使用比理论上认为正确的使用更为广泛；（e）与家长主义原则以及责任与尊重患者自主权之间的联系。
理论上对非正式强制手段的不赞成在实践中常常被推翻。这种不一致在不同社会文化背景中都存在，往往使专业人员感到不安，需要更多的辩论和指导。
