Tvang i psykisk helsevern: En sammenligning av holdninger blant ansatte og pasienter

Guri Sjøtun Lydersen, Marte Morken, O. Aasland, Reidar Pedersen, Tonje Lossius Husum
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Abstract

Aim: Few studies have compared attitudes to coercion in both patients and healthcare professionals, and the Staff Attitude to Coercion Scale (SACS) has not previously been used in Norway. The purpose of the current study was to examine differences in staff and patient attitudes using SACS. Method: The study included 1160 employees and 332 patients. Factor analysis was used to compare SACS's three-factor model across the two groups. Independent t-tests were used to compare staff and patient attitudes on the three SACS dimensions: coercion as potentially offensive and/or harmful to the patient, coercion as care and safety, and coercion as treatment. Results: We found statistically significant differences between staff and patients' reported attitudes on two SACS dimensions. Patients reported coercion as more offensive and/or harmful than did with staff (t (495) = 7.96, p <.001). Staff reported coercion as care and safety to a higher degree than did patients (t (444) = -5.91, p <.001). Conclusion: The results suggest the presence of attitudinal differences between patients and staff. One limitation of the study is that SACS has not been validated for use by patients. Generally, the results imply a discrepancy in attitudes that may lead to a weak treatment alliance between staff and patients. Keywords: coercion, mental health care, ethical challenges, SACS, staff-patient alliance.
目的:很少有研究比较患者和医疗保健专业人员对胁迫的态度,工作人员对胁迫的态度量表(SACS)以前没有在挪威使用过。本研究的目的是检查工作人员和患者使用SACS态度的差异。方法:纳入1160名员工和332名患者。采用因子分析比较两组SACS的三因素模型。独立t检验用于比较工作人员和患者对SACS三个维度的态度:胁迫作为潜在冒犯和/或有害于患者,胁迫作为护理和安全,胁迫作为治疗。结果:我们发现工作人员和患者在SACS两个维度上的态度有统计学上的显著差异。患者报告胁迫比工作人员更具攻击性和/或危害性(t (495) = 7.96, p <.001)。工作人员将强迫作为护理和安全的程度高于患者(t (444) = -5.91, p <.001)。结论:患者与医护人员之间存在态度差异。该研究的一个局限性是SACS尚未被证实可用于患者。一般来说,结果暗示了态度上的差异,这可能导致医护人员和患者之间的治疗联盟薄弱。关键词:胁迫,精神卫生保健,伦理挑战,SACS,医患联盟
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