Di Lorenzo Rosaria, Mucchi Francesca, Magnani Nadia, Starace Fabrizio, Bonisoli Jessica, Bottone Carolina, Ragazzini Ilaria, Ferri Paola, Marrama Donatella
Department of Mental Health and Drug Abuse, AUSL-Modena, 41121 Modena, Italy.
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.
J Clin Med. 2025 Apr 22;14(9):2886. doi: 10.3390/jcm14092886.
: The use of coercive measures in psychiatry is an ethically controversial issue. Staff attitude towards coercive measures could explain the different application frequencies of coercive measures across psychiatric services. : We analyzed the attitude towards coercion held by professionals working in a psychiatric department using the Staff Attitude to Coercion Scale (SACS). We statistically evaluated the correlation between the SACS score and the demographic and work characteristics of professionals. : The most represented category of participants was nurses (73.03%). Most professionals worked in a Mental Health Community Service (MHCS) (72.09%). We reported a score of 41.9 ± 8.8 SD in total SACS and high scores in two SACS factors: "Coercion as offending" and "Coercion as care and security". Professionals working in Service for Psychiatric Diagnosis and Care (SPDC) showed reduced scores in total SACS and the SACS dimension "Coercion as offending" score. Place of work, particularly "working in SPDC", was statistically significantly associated with total SACS in a positive way and with the "Coercion as offending" score in a negative way in our regression multivariate test. : Our professionals showed a predominantly critical and pragmatic attitude towards coercive measures. The professionals who are more frequently exposed to violent and aggressive behavior, such as those who work in SPDC, showed a reduced critical attitude towards coercion in comparison with those working in MHCS, suggesting that exposure to violence can shape the response of professionals.
精神病学中强制措施的使用是一个在伦理上存在争议的问题。工作人员对强制措施的态度可以解释不同精神科服务中强制措施应用频率的差异。
我们使用工作人员对强制措施态度量表(SACS)分析了精神科专业人员对强制措施的态度。我们对SACS得分与专业人员的人口统计学和工作特征之间的相关性进行了统计学评估。
参与者中占比最大的类别是护士(73.03%)。大多数专业人员在心理健康社区服务(MHCS)部门工作(72.09%)。我们报告SACS总分平均得分为41.9±8.8标准差,并且在SACS的两个因子上得分较高:“将强制措施视为冒犯”和“将强制措施视为关怀与安全”。在精神病诊断与护理服务(SPDC)部门工作的专业人员在SACS总分以及“将强制措施视为冒犯”这一维度上得分较低。在我们的多元回归测试中,工作地点,尤其是“在SPDC工作”,与SACS总分呈显著正相关,与“将强制措施视为冒犯”得分呈显著负相关。
我们的专业人员对强制措施主要持批评和务实的态度。与在MHCS工作的人员相比,那些更频繁接触暴力和攻击性行为的专业人员,如在SPDC工作的人员,对强制措施的批评态度有所降低,这表明接触暴力会影响专业人员的反应。