Two Scales for Measuring Patients' Perceptions for Coercion During Mental Hospital Admission

Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213, USA.
Behavioral Sciences & the Law (Impact Factor: 0.96). 06/1993; 11(3):307-21. DOI: 10.1002/bsl.2370110308
Source: PubMed


Legal and extra-legal coercion are pervasive in mental hospital admission and there are sharp disputes about its appropriate role. This article presents two scales for measuring psychiatric patients' perceptions of coercion during hospital admission and reports data on these scales' internal consistency. We measure patients' perceptions of coercion by asking questions, in either an interview or questionnaire format, about their experience of lack of control, choice, influence, and freedom in hospital admission. Patients' responses to questions about their perceptions of coercion were highly internally consistent. The internal consistency of the scale was robust with respect to variation in site, instrument format, patient population, and interview procedure. Correspondence analysis was used to construct two numerical scales of perceived coercion.

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    • "To determine the level of perceived coercion, level of procedural justice, and perceived pressures an individual experienced on admission to a hospital, we used the MacArthur Admission Experience Interview (Gardner et al., 1993). This scale comprises 14 true/ false statements about an individual's hospital admission experience. "
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    ABSTRACT: The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.
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    • "Consistent with previous empirical literature on application of procedural justice theory to diversion programs (e.g., O'Keefe, 2006; Poythress et al., 2002; Tyler, 2006), two Likert-scale self-report measures were used to assess thematic components of procedural justice: the Perceptions of Procedural Justice (PPJ; Cascardi, Poythress, & Hall, 2000; Poythress et al., 2002) and the Impact of Hearing (IOH; adapted from Poythress et al., 2002). The MacArthur Admission Experience Survey: Short Form (MAES; Gardner et al., 1993) was also administered. On the PPJ, participants are asked to rate on a Likert scale the degree to which (1) they had an opportunity to tell the judge about their personal and legal circumstances, (2) they felt that the judge seemed genuinely interested in them as a person, (3) the judge treated them with respect, (4) the judge treated them fairly, (5) they were satisfied with how the judge treated them and dealt with their case, and (6) they were satisfied with the decisions made regarding their case. "
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    • "These items are scored to arrive at a global score of perceived coercion. The MPCS has been used in a variety of psychiatric settings (Rain et al., 2003) and has demonstrated psychometrically sound properties which are comparable to more lengthy interview-based measures of perceived coercion (Gardner et al., 1993). "
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