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精神科における強制の連続体は本当に連続体なのか?統計的含意分析
Philippe Golay1,2, Benedetta Silva1,3, Debora Martinez1
1Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland.
まとめ
メンタルヘルスケアにおけるインフォーマルな強制、特に子の親権に関するものは、フォーマルな強制よりも重症であると認識される可能性がある。これは、強制を厳密な連続体と見なす従来の考え方に疑問を投げかけ、患者の経験を強調するものである。
科学分野:
- 精神医学
- メンタルヘルス法
- 社会学
背景:
- 精神科におけるフォーマルな強制は十分に研究されているが、インフォーマルな強制は依然として十分に研究されていない。
- 強制はしばしば連続体として概念化され、フォーマルな強制が最も重症な形態である。
- インフォーマルな強制とフォーマルな強制の比較重症度は、患者の視点からはよく理解されていない。
研究 の 目的:
- フォーマルな精神科的強制の知覚された重症度と、重度のインフォーマルな強制の4つの領域を比較すること。
- 経済的、住居、刑事司法、子の親権の状況における強制に対する患者の認識を調査すること。
主な方法:
- ラスク解析と統計的含意分析が用いられた。
- 合計456人の精神科患者が研究に参加した。
主要な成果:
- 重度のインフォーマルな強制の4つの領域すべてが、フォーマルな強制よりも重症であると認識された。
- 子の親権に関連する強制は、インフォーマルな強制の最も重症な形態であると認識された。
- 結果は、インフォーマルな強制の重症度が、従来の強制の連続体モデルと一致しない可能性を示唆している。
結論:
- インフォーマルな強制、特に子の親権事件における知覚された重症度は、確立された「強制の連続体」モデルに疑問を投げかける。
- 強制の重症度に関する患者の生きた経験は、フォーマルな分類とは大きく異なる可能性がある。
- 精神科ケアにおける知覚された強制のニュアンスを理解するためには、さらなる研究が必要である。
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