Lessard-Deschênes Clara, Pariseau-Legault Pierre, Billé Vincent, Sergerie-Richard Sophie, Hudson Emilie, Silva Benedetta, Drouin Jean-Simon, Désilets Marie, Goulet Marie-Hélène
Faculté des Sciences Infirmières, Université de Montréal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8, Canada.
Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada.
Healthcare (Basel). 2025 Jul 30;13(15):1868. doi: 10.3390/healthcare13151868.
BACKGROUND/OBJECTIVES: Perceived coercion has been associated with significant negative outcomes, including service avoidance and psychological distress. Despite growing interest, no recent comprehensive review has mapped the full range of factors influencing this experience. This scoping review aimed to synthesize and present the state of knowledge on the factors associated with perceived coercion by adults receiving psychiatric care.
Following the Joanna Briggs Institute methodology, a systematic search of five databases and grey literature was conducted for publications from 1990 to 2025 in English and French. A total of 143 sources were included and thematically analyzed. Consultation with experts and individuals with lived experience enriched the interpretation of findings.
Five categories of factors were identified: individual, clinical, relational, legal, and structural. Relational and legal factors were most consistently associated with perceived coercion, while individual and clinical factors showed inconsistent findings. Structural influences were underexamined but significantly shaped the experiences of the individuals receiving care.
Perceived coercion arises from a complex dynamic of individual, relational, and systemic influences. Reducing coercion requires moving beyond individual-level factors to address structural conditions and policy frameworks. Future research should prioritize qualitative and intersectional approaches and amplify the voices of those most affected by coercive practices in psychiatric care.
背景/目的：感知到的强制力与显著的负面结果相关，包括避免接受服务和心理困扰。尽管人们对此的兴趣日益浓厚，但最近尚无全面综述梳理影响这种体验的所有因素。本范围综述旨在综合并呈现有关接受精神科护理的成年人感知到的强制力相关因素的知识现状。
按照乔安娜·布里格斯研究所的方法，对五个数据库和灰色文献进行系统检索，查找1990年至2025年以英文和法文发表的文献。共纳入143篇文献并进行主题分析。与专家和有实际经历的个人进行磋商，丰富了对研究结果的解读。
确定了五类因素：个人因素、临床因素、关系因素、法律因素和结构因素。关系因素和法律因素与感知到的强制力关联最为一致，而个人因素和临床因素的研究结果则不一致。对结构影响的研究不足，但对接受护理的个人体验有显著影响。
感知到的强制力源于个人、关系和系统影响的复杂动态。减少强制力需要超越个人层面的因素，以解决结构条件和政策框架问题。未来的研究应优先采用定性和交叉性方法，并放大那些在精神科护理中受强制行为影响最大的人的声音。
