[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. · 1.81 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Involuntary admission is still raising in numbers and as a procedure a widely discussed subject from ethical point of view. A common dilemma is the tension between individual freedom and the need to protect the patient. Patients who are coerced during the admission process often report negative feelings or trauma. Finding out quality issues remains a challenge for providing good care during coercive admission.
This study aims to explore themes from patients' and professionals' perspectives within scientific literature on involuntary admission.
A literature review of English articles using Academic Search Elite, Cinahl, Medline, PubMed and Social Science Journals for the period 1995-2012 was conducted. Additional studies were identified using the National Centre for Biotechnology Information (NCBI). Search terms included involuntary, hospitalisation, ethical, admission, nursing home, coercion and factor. Finally, twenty-two articles were included and analysed out of 1216.
Articles were divided between those describing themes from patients' perspective and articles describing themes from professionals' perspective. Findings show that most experiences of patients can be traced back to one core experience: not being listened to or listened to. When patients experience being listened to genuinely, they feel more respected as a human being. The challenge for the professional carer seems to explicitly pay attention and stay in touch with the patients' emotional struggles while making the necessarily decision to admit the patient to prevent harm. Quality of care during coercive admission improves when professionals are able to do justice to both inside and outside perspectives simultaneously.
Scandinavian Journal of Caring Sciences 08/2013; · 0.89 Impact Factor
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