Department of Mental Health, Biomedical Research Institute of Malaga (IBIMA), University General Hospital of Málaga, Málaga, Spain.
Andalucía Tech, Faculty of Psychology, University of Málaga, Málaga, Spain.
Int J Ment Health Nurs. 2019 Apr;28(2):448-456. doi: 10.1111/inm.12546. Epub 2018 Sep 21.
Coercive measures are frequently used in psychiatric hospitalization. However, there are few studies that analyse perceived coercion, post-traumatic stress, and subjective satisfaction with the hospitalization treatment associated with different types of coercive measures. The sample consisted of 111 patients admitted to two psychiatric units and divided into three groups based on the measure applied: involuntary medication (N = 41), mechanical restraint (N = 32), and combined measures (mechanical restraint and involuntary medication; N = 38). The outcome variables were perceived coercion evaluated with the Coercion Experience Scale (CES), post-traumatic stress evaluated with the Davidson Trauma Scale (DTS), and satisfaction with the treatment evaluated with the Client's Assessment of Treatment (CAT). The results found higher levels of perceived coercion associated with the use of mechanical restraint (P = 0.002) and combined measures (P < 0.001) in comparison with involuntary medication. Additionally, in relation to post-traumatic stress, mechanical restraint (P = 0.013) and combined measures (P = 0.004) were more stressful compared to involuntary medication. Finally, the use of combined measures was associated with lower satisfaction with inpatient psychiatric treatment compared to the use of involuntary medication (P = 0.006). The following recommendation would be consistent with the results found: if a patient does not specify a preference for some type of measure, involuntary medication could be used and mechanical restraint avoided, especially when used in combination with involuntary medication.
强制手段经常被应用于精神科住院治疗中。然而，很少有研究分析与不同类型的强制手段相关的感知强制、创伤后应激和对住院治疗的主观满意度。该样本由 111 名被收入两家精神病院的患者组成，根据所应用的措施将他们分为三组：非自愿用药（N=41）、机械约束（N=32）和联合措施（机械约束和非自愿用药；N=38）。结果变量是用强制体验量表（CES）评估的感知强制、用大卫森创伤量表（DTS）评估的创伤后应激和用客户对治疗的评估（CAT）评估的治疗满意度。结果发现，与非自愿用药相比，使用机械约束（P=0.002）和联合措施（P<0.001）与更高水平的感知强制相关。此外，在创伤后应激方面，机械约束（P=0.013）和联合措施（P=0.004）比非自愿用药更具压力。最后，与使用非自愿用药相比，使用联合措施与对住院精神病治疗的满意度降低相关（P=0.006）。与研究结果一致的建议是：如果患者没有对某种类型的措施表示偏好，可以使用非自愿用药并避免使用机械约束，尤其是在与非自愿用药联合使用时。
