1 University of Oslo, Oslo, Norway.
2 Oslo and Akershus University College, Oslo, Norway.
Qual Health Res. 2018 May;28(6):900-915. doi: 10.1177/1049732317750120. Epub 2018 Jan 8.
Coercion in mental healthcare does not only affect the patient, but also the patient's families. Using data from interviews with 36 family members of adult and adolescent people with mental health problems and coercion experiences, the present narrative study explores family members' existential and moral dilemmas regarding coercion and the factors influencing these dilemmas. Four major themes are identified: the ambiguity of coercion; struggling to stay connected and establishing collaboration; worries and distress regarding compulsory care; and dilemmas regarding initiating coercion. Subsequently, coercion can reduce, but also add burden for the family by creating strains on family relations, dilemmas, (moral) distress, and retrospective regrets; this is reinforced by the lack of information or involvement and low-quality care. Subsequently, it is a moral obligation to develop more responsive health services and professionals who provide more guidance and balanced information to increase the possibilities for voluntary alternatives and informed decision making.
在精神卫生保健中的强制不仅会影响患者，还会影响到患者的家属。本叙事研究使用了对 36 名成年和青少年精神健康问题患者及其家属的访谈数据，探讨了他们在强制问题上的存在主义和道德困境，以及影响这些困境的因素。确定了四个主要主题：强制的模糊性；努力保持联系和建立合作；对强制护理的担忧和困扰；以及启动强制的困境。随后，强制可能会通过对家庭关系、困境、（道德）困扰和事后遗憾产生影响而减轻负担；而缺乏信息或参与以及低质量的护理则加剧了这种情况。因此，有必要开发更具响应性的卫生服务和专业人员，为他们提供更多的指导和平衡的信息，以增加自愿选择和知情决策的可能性，这是一种道德义务。
