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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    • "Cronbach's α was calculated for each of the scales to examine internal consistency. The validity of the AES instrument was examined by comparing scores graphically to the original study (Gardner et al., 1993), and by the calculated correlations between different scales of the instrument. Cronbach's α was 0.79 for the perceived coercion scale, 0.67 for negative pressures, 0.78 for voice, and 0.80 for the negative emotions in the affective reactions to hospitalization scale, suggesting good internal consistency. "

    Psychology Crime and Law 10/2015; DOI:10.1080/1068316X.2015.1109086 · 0.69 Impact Factor
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    • "Within this study we did not want to overburden participants within the psychiatric unit with extensive scales or questionnaires, thus another limitation for this study was the use of single-item questions that hindered our ability to test the reliability and validity of the questions asked. Future research can address this issue by using full coercion scales such as the MacArthur Perceived Coercion Scale (Gardner et al., 1993). In the same vein, the psychiatric unit in which this study was conducted is a fast moving and often chaotic environment. "
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    ABSTRACT: Although patients with mental health issues are increasingly turning to emergency departments to receive mental health services, emergency department staff report being ill-equipped to assist this population. The purpose of this study was threefold. First, we wanted to understand how patients with mental health emergencies who are later admitted to psychiatric units perceived their experience in the emergency department, specifically whether they felt that their experience was helpful or harmful (physically or psychologically) and whether they felt like they were treated differently than patients with medical emergencies. Second, we wanted to understand whether these experiences were impacted by patients' perceptions that they were coerced into seeking treatment. Third, we wanted to gain patients' perspectives on how emergency departments could be modified to better accommodate mental health emergencies. We conducted interviews with 49 patients in an inpatient unit at a large general hospital in British Columbia, Canada, shortly after patients were triaged from the emergency department. We found that roughly half of patients endorsed high levels of feeling helped, with the other half endorsing low levels. Additionally, perceptions of having control over coming to the emergency department were predictive of patients' perceptions of being helped and psychologically hurt. © 2015, Copyright © International Association of Forensic Mental Health Services.
    International Journal of Forensic Mental Health 07/2015; 14(3):161-171. DOI:10.1080/14999013.2015.1073195 · 1.05 Impact Factor
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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.
    The Journal of nervous and mental disease 03/2014; 202(3):186-92. DOI:10.1097/NMD.0000000000000102 · 1.69 Impact Factor
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