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

ABSTRACT 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.

  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aims to investigate treatment drop-out, and the associated roles of motivation, alliance, and behaviour change exhibited over the first four weeks of hospitalised treatment for anorexia. 90 participants meeting DSM-IV criteria for anorexia nervosa completed questionnaires at admission, and four weeks into treatment. Weight data was collected over this same time period. At the end of treatment, participants were categorised into completer or premature termination groups. The overall rate of premature termination was 57.8%. Those who prematurely terminated treatment demonstrated lower discharge BMI (p<.0005), and weight gain (p<.0005) than those who completed. Therapeutic alliance proved significantly different between outcome groups at admission (p=.004). End-of-treatment outcomes for those who do not complete treatment are invariably poor. Therapeutic alliance appears to be a particularly important factor in this area.
    Eating behaviors 04/2013; 14(2):119-23. DOI:10.1016/j.eatbeh.2013.01.007
  • Source
    • "The 5-item perceived coercion subscale (PCS) of the 15-item Admission Experience Survey (AES; Gardner et al. 1993) was administered to assess participants' perceptions of coercive admission procedures. The AES has demonstrated high internal consistency and reliability across groups (Gardner et al. 1993). The PCS consists of true/false statements about having freedom, choice, idea, control, and influence regarding the current hospital admission (e.g., ''I had a lot of control over whether I went into the hospital''). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient care, yet more research is needed to understand the factors that influence consumers' perceptions of coercion and its effects on satisfaction, including potential "downstream" effects of past coercive events on current treatment satisfaction. The current study examined associations between objective and subjective indices of coercive treatments and patients' satisfaction with care in a psychiatric inpatient sample (N = 240). Lower satisfaction ratings were independently associated with three coercive treatment variables: current involuntary admission, perceived coercion during current admission, and self-reported history of being refused a requested medication. Albeit preliminary, these results document associations between patients' satisfaction ratings and their subjective experiences of coercion during both current and prior hospitalizations.
    Community Mental Health Journal 09/2012; DOI:10.1007/s10597-012-9539-5
Show more