{"title":"住院精神病学非正式强迫的概念化:范围回顾","authors":"Simone Beeri, Eliane Baumberger, Sandra Zwakhalen, Sabine Hahn","doi":"10.1111/inm.70076","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <p>Coercion in mental health care is complex and controversial, often seen as a potential human rights violation. Coercion can manifest in various forms and is subject to ethical and legal judgement. Formal coercion includes measures restricting movement or providing treatment without consent. Informal coercion involves the use of communication and subtle interventions by mental health professionals to control, influence, manipulate or pressure patients, aiming to elicit specific behaviours and shape their decisions. Informal coercion often occurs in psychiatric care. However, it is not legislated; it is not discussed in clinical guidelines, and it is not formalised or documented. This scoping review aims to map the current understanding of informal coercion in inpatient psychiatry. Six databases were searched for studies examining definitions and conceptualisations of informal coercion. Data extraction included a summary and comparison of study characteristics, definitions and conceptualisations followed by thematic analysis using Braun and Clarke's approach. Twenty-nine articles were included in the synthesis. The analysis led to the proposal of a definition of informal coercion and identified three key themes: first, the professionals' intentions, with attributes identified as patient protection or self-protection; second, the methods used, including the attributes communication patterns, ‘legal’ coercion, deception, manipulation and abuse of power; and third, contextual factors leading to informal coercion, with attributes such as cultural adaptation, rule conformity and professionals' attitudes and skills. This study provides a conceptualisation for understanding informal coercion in inpatient psychiatry, highlighting its complexity and the need for ethical and professional reflection. Developing clear guidelines and standards is essential for protecting patient autonomy and dignity while enabling effective therapeutic interventions.</p>\n </section>\n \n <section>\n \n <h3> Trail Registration</h3>\n \n <p>The research protocol was registered in the Open Science Framework (https://osf.io/ck3et).</p>\n </section>\n </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Conceptualisation of Informal Coercion in Inpatient Psychiatry: A Scoping Review\",\"authors\":\"Simone Beeri, Eliane Baumberger, Sandra Zwakhalen, Sabine Hahn\",\"doi\":\"10.1111/inm.70076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <p>Coercion in mental health care is complex and controversial, often seen as a potential human rights violation. Coercion can manifest in various forms and is subject to ethical and legal judgement. Formal coercion includes measures restricting movement or providing treatment without consent. Informal coercion involves the use of communication and subtle interventions by mental health professionals to control, influence, manipulate or pressure patients, aiming to elicit specific behaviours and shape their decisions. Informal coercion often occurs in psychiatric care. However, it is not legislated; it is not discussed in clinical guidelines, and it is not formalised or documented. This scoping review aims to map the current understanding of informal coercion in inpatient psychiatry. Six databases were searched for studies examining definitions and conceptualisations of informal coercion. Data extraction included a summary and comparison of study characteristics, definitions and conceptualisations followed by thematic analysis using Braun and Clarke's approach. Twenty-nine articles were included in the synthesis. The analysis led to the proposal of a definition of informal coercion and identified three key themes: first, the professionals' intentions, with attributes identified as patient protection or self-protection; second, the methods used, including the attributes communication patterns, ‘legal’ coercion, deception, manipulation and abuse of power; and third, contextual factors leading to informal coercion, with attributes such as cultural adaptation, rule conformity and professionals' attitudes and skills. This study provides a conceptualisation for understanding informal coercion in inpatient psychiatry, highlighting its complexity and the need for ethical and professional reflection. Developing clear guidelines and standards is essential for protecting patient autonomy and dignity while enabling effective therapeutic interventions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Trail Registration</h3>\\n \\n <p>The research protocol was registered in the Open Science Framework (https://osf.io/ck3et).</p>\\n </section>\\n </div>\",\"PeriodicalId\":14007,\"journal\":{\"name\":\"International Journal of Mental Health Nursing\",\"volume\":\"34 3\",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Mental Health Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/inm.70076\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Mental Health Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/inm.70076","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Conceptualisation of Informal Coercion in Inpatient Psychiatry: A Scoping Review
Coercion in mental health care is complex and controversial, often seen as a potential human rights violation. Coercion can manifest in various forms and is subject to ethical and legal judgement. Formal coercion includes measures restricting movement or providing treatment without consent. Informal coercion involves the use of communication and subtle interventions by mental health professionals to control, influence, manipulate or pressure patients, aiming to elicit specific behaviours and shape their decisions. Informal coercion often occurs in psychiatric care. However, it is not legislated; it is not discussed in clinical guidelines, and it is not formalised or documented. This scoping review aims to map the current understanding of informal coercion in inpatient psychiatry. Six databases were searched for studies examining definitions and conceptualisations of informal coercion. Data extraction included a summary and comparison of study characteristics, definitions and conceptualisations followed by thematic analysis using Braun and Clarke's approach. Twenty-nine articles were included in the synthesis. The analysis led to the proposal of a definition of informal coercion and identified three key themes: first, the professionals' intentions, with attributes identified as patient protection or self-protection; second, the methods used, including the attributes communication patterns, ‘legal’ coercion, deception, manipulation and abuse of power; and third, contextual factors leading to informal coercion, with attributes such as cultural adaptation, rule conformity and professionals' attitudes and skills. This study provides a conceptualisation for understanding informal coercion in inpatient psychiatry, highlighting its complexity and the need for ethical and professional reflection. Developing clear guidelines and standards is essential for protecting patient autonomy and dignity while enabling effective therapeutic interventions.
Trail Registration
The research protocol was registered in the Open Science Framework (https://osf.io/ck3et).
期刊介绍:
The International Journal of Mental Health Nursing is the official journal of the Australian College of Mental Health Nurses Inc. It is a fully refereed journal that examines current trends and developments in mental health practice and research.
The International Journal of Mental Health Nursing provides a forum for the exchange of ideas on all issues of relevance to mental health nursing. The Journal informs you of developments in mental health nursing practice and research, directions in education and training, professional issues, management approaches, policy development, ethical questions, theoretical inquiry, and clinical issues.
The Journal publishes feature articles, review articles, clinical notes, research notes and book reviews. Contributions on any aspect of mental health nursing are welcomed.
Statements and opinions expressed in the journal reflect the views of the authors and are not necessarily endorsed by the Australian College of Mental Health Nurses Inc.