强制措施的感知强制和感知理由之间的关系 - 一个随机对照试验的二次分析
Alexandre Wullschleger1,2, Angelika Vandamme3, Juliane Mielau3
1Department of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität Zu Berlin, Campus Charité Mitte, Berlin, Germany. alexandre.wullschleger@hcuge.ch.
BMC psychiatry
|October 2, 2023
概括
患者认为强制措施是由工作人员的行动证明的,他们报告了更高的强制. 减少强制措施需要透明的决策,特别是对于有负面症状的患者.
科学领域:
- 精神病学是一个精神病学.
- 心理健康研究 心理健康研究
- 患者体验 患者体验
背景情况:
- 对胁迫的主观感知是心理健康的一个关键结果.
- 了解感知到的理由与强迫程度之间的联系至关重要.
- 关于患者如何评估强制措施的正当性,目前的研究有限.
研究的目的:
- 分析患者对强制措施的合理性评估与他们感知到的强制程度之间的关系.
- 调查影响精神病学环境中对强迫行为的主观经验的因素.
主要方法:
- 一个多中心随机对照试验 (RCT) 在强制后审查的二次分析.
- 包括经历至少一次强制措施的患者.
- 通过使用强迫经验量表 (CES) 评估主观胁迫,并通过多变量回归分析了理由评估 (与患者相关的与员工相关的).
主要成果:
- 97名参与者完成了CES.
- 更高的强迫感 (CES分数) 与与工作人员有关的理由相关 (B=0.540,p<0.001).
- 负面症状 (B=0.265,p=0.011) 和机械约束与隔离 (B=-0.343,p=0.017) 也与强迫程度有关.
结论:
- 与工作人员相关的理由 (例如,随意,无能) 与感知到的强迫感增加有关.
- 需要多专业的努力,以尽量减少强制措施,并加强透明的决策.
- 强制减少计划应优先考虑具有高负面症状的患者.
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