强制措施对阿姆斯特丹非自愿入院患者治疗结果的影响
L F M van der Post1, K J Nusselder1, J Peen1
1Research Department, ARKIN Mental Health Care, Amsterdam, Netherlands.
Frontiers in psychiatry
|October 9, 2023
概括
非自愿的精神病医院入院往往涉及强制措施. 这项研究发现,虽然隔离或强制服用药物并没有恶化结果,但没有这些措施的患者在HoNOS尺度上略有改善.
科学领域:
- 精神病学是一个精神病学.
- 心理健康服务研究 心理健康服务研究
- 临床心理学 临床心理学
背景情况:
- 在过去的40年里,非自愿的精神病医院入院在欧洲有所增加.
- 大约40%的患者被强迫接受强制措施,如隔离,身体限制或强制药物治疗.
- 了解这些强制措施对治疗结果的影响对于改善患者护理至关重要.
研究的目的:
- 调查在非自愿精神病医院入院期间,强制措施的患者和未受到强制措施的患者之间的治疗结果是否不同.
- 分析隔离,身体克制或强制药物的使用与患者结果之间的关联.
主要方法:
- 研究了一组786名非自愿入院阿姆斯特丹诊所的患者.
- 国家健康结果表 (HoNOS) 用于衡量治疗结果.
- 应用了通用线性模型来分析强制措施与结果差异之间的关联,根据诊断,初始疾病严重程度和治疗持续时间进行调整.
主要成果:
- 19%的患者被隔离在高安全室 (HSR),24%被隔离在自己的房间和/或接受强制药物治疗.
- 在调整后,HSR组的患者与没有强迫的患者相比,HONOS差异得分降低了2.4个点 (p=0.003).
- 被隔离在自己的房间/接受强制药物的患者显示HoNOS差异得分 (p=0.001) 低了2.6个点,表明改善较小.
结论:
- 强制措施,包括隔离和强制服用药物,对这一队列的五分之二的患者进行了应用.
- 与那些经历了强制措施的患者相比,没有受到强制措施的患者平均在HoNOS分数中表现出更大的改善.
- 该研究无法证实或排除使用强迫和治疗结果之间的因果关系.
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