Charité University Medicine Berlin, Department of Psychiatry at St. Hedwig Hospital (PUK Charité im SHK), Grosse Hamburger Str. 5-11, 10115, Berlin, Germany.
Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
J Psychiatr Res. 2022 Sep;153:11-17. doi: 10.1016/j.jpsychires.2022.06.048. Epub 2022 Jun 29.
Coercive measures (CM) and involuntary admission to psychiatric treatment can have detrimental consequences for patients. Past research shows that certain clinical, treatment and admission-related characteristics put patients at a higher risk of experiencing CM and involuntary admission. Although of high societal importance, the association between patients' communication ability and CM and involuntary admission has not been subject of past research. To explicitly examine this association the authors conducted a retrospective study using data from patients admitted to psychiatric inpatient treatment via the emergency room at Charité St. Hedwig Hospital, Berlin in 2019. As independent variable, communication ability at admission was recorded (perfect; limited due to language or other reasons; impossible due to language or other reasons) along with possibly confounding variables including demographic, clinical and admission-related details. As dependent variables, involuntary admission and CM were recorded. Multivariate logistic regression analyses were conducted examining the association between communication ability and involuntary admission and CM. In a sample of N = 1556, controlling for potential confounders, limited (OR = 3.08; p = .004) or no communication ability (OR = 4.02; p = .003) due to language barrier or limited (OR = 3.10; p < .001) or no communication ability (OR = 13.71; p < .001) due to other factors were significant predictors for involuntary admission. Limited communication ability due to language barrier (OR = 4.53; p < .001) and limited (OR = 1.58; p = .034) and no communication ability (OR = 3.55; p < .001) due to other factors were significant predictors for CM. These findings show that patients impaired in their communication ability are at higher risk of involuntary admission and CM and highlight the urgency of implementing appropriate interventions facilitating communication during admission and treatment.
强制性措施（CM）和非自愿住院治疗可能对患者产生不利影响。过去的研究表明，某些临床、治疗和入院相关特征使患者面临更高的经历 CM 和非自愿住院的风险。尽管具有高度的社会重要性，但患者沟通能力与 CM 和非自愿住院之间的关联尚未成为过去研究的主题。为了明确研究这种关联，作者使用了 2019 年柏林夏洛蒂医院急诊室收治的精神科住院患者的数据进行了回顾性研究。入院时的沟通能力（完全；因语言或其他原因受限；因语言或其他原因无法进行）被记录为自变量，同时记录了可能的混杂变量，包括人口统计学、临床和入院相关细节。作为因变量，记录了非自愿入院和 CM。进行了多变量逻辑回归分析，以检查沟通能力与非自愿入院和 CM 之间的关联。在 N = 1556 的样本中，控制潜在混杂因素后，由于语言障碍而导致的有限（OR = 3.08；p =.004）或无沟通能力（OR = 4.02；p =.003），或由于其他因素而导致的有限（OR = 3.10；p <.001）或无沟通能力（OR = 13.71；p <.001）是非自愿入院的显著预测因素。由于语言障碍而导致的有限沟通能力（OR = 4.53；p <.001），以及由于其他因素而导致的有限（OR = 1.58；p =.034）和无沟通能力（OR = 3.55；p <.001）是 CM 的显著预测因素。这些发现表明，沟通能力受损的患者更有可能非自愿入院和接受 CM，这突显了在入院和治疗期间实施适当干预措施以促进沟通的紧迫性。
