Department of Human Neurosciences, University of Rome "Sapienza", Italy.
Psychiatry Residency Training Program, Faculty of Medicine and Psychology, University of Rome "Sapienza", Italy.
Int J Law Psychiatry. 2019 Jan-Feb;62:111-116. doi: 10.1016/j.ijlp.2018.12.006. Epub 2018 Dec 19.
Coercive treatments are often regarded as an inevitable and yet highly debated feature of psychiatric care. Perceived coercion is often reported by patients involuntarily committed as well as their voluntary counterparts. The Admission Experience Survey (AES) is a reliable tool for measuring perceived coercion in mental hospital admission. We developed the Italian AES (I-AES) through translation back-translation and administered it to 156 acutely hospitalized patients (48% women, 69% voluntarily committed) in two university hospitals in Rome (Policlinico Umberto I, Sant'Andrea Hospital). A principal component analysis (PCA) with equamax rotation was conducted. The I-AES showed good internal consistency (Cronbach's alpha = 0.90); Guttmann split-half reliability coefficient was 0.90. AES total score significantly differed between voluntary and involuntary committed patients (5.08 ± 4.1 vs. 8.1 ± 4.9, p < .05). PCA disclosed a three-factor solution explaining 59.3 of the variance. Some discrepancies were found between the factor structure of the I-AES and the original version. I-AES total score was positively associated with numbers of previous involuntarily hospitalization (r = 0.20, p < .05) and psychiatric symptoms' severity (r = 0.22, p < .02). I-AES and its proposed new factor structure proved to be reliable to assess perceived coercion in mental hospital admission. Consequently, it may represent a helpful instrument for the study and reduction of patients' levels of perceived coercion.
强制治疗通常被视为精神科护理中不可避免但备受争议的特征。非自愿住院的患者和自愿住院的患者都经常报告感到被强制。入院体验调查（AES）是衡量精神科入院时感知强制的可靠工具。我们通过翻译-回译开发了意大利 AES（I-AES），并在罗马的两所大学医院（Umberto I 综合医院和 Sant'Andrea 医院）对 156 名急性住院患者（48%为女性，69%为自愿住院）进行了测试。采用等最大值旋转的主成分分析（PCA）进行分析。I-AES 显示出良好的内部一致性（克朗巴赫 α=0.90）；Guttmann 分半信度系数为 0.90。自愿和非自愿住院患者的 AES 总分差异显著（5.08±4.1 与 8.1±4.9，p<0.05）。PCA 揭示了一个三因素解决方案，解释了 59.3%的方差。I-AES 的因子结构与原始版本之间存在一些差异。I-AES 总分与既往非自愿住院次数（r=0.20，p<0.05）和精神症状严重程度（r=0.22，p<0.02）呈正相关。I-AES 及其提出的新因子结构被证明可用于评估精神科入院时的感知强制，因此可能是研究和降低患者感知强制程度的有用工具。
