The assumptions of the traumatic effects of coercive measures as described in the literature will be examined in the present study. The research questions are how coercive measures are experienced by patients, to what extent these measures are…
ID
Source
Brief title
Condition
- Psychiatric disorders NEC
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary study parameters are the experiences with regard to coercive measures,
the frequency and intensity of PTSD symptoms during recording and three months
after discharge and coping strategies.
Secondary outcome
The following background variables are mapped:
* Gender
* Age
* Ethnicity
* Main diagnosis
* Severity psychopathology (K Axis)
* Type coercive measure
* Previous coercion experience
* Events during current admission (PEQ)
* Positive experience during current admission
* Duration admission
* Subscales Coercion Experience Scale (CES)
* Subscales coping strategies (DUBRICSI)
Possible selection bias will be mapped through an inventory of characteristics
of non-participating patients. These are: the reason for not being able /
willing to take part in the survey, the main diagnosis, gender, age, admission
time and the reason for admission.
Background summary
A cultural shift in the area of compulsion and coercion is going on in Dutch
Mental Health Care since the year 2000. The emphasis is increasingly placed on
the prevention of use of coercion and compulsion. In addition, there is a focus
on the effects and impact of coercive measures for patients. It is assumed that
coercive measures used in mental healthcare can be traumatizing for the
patients. In the literature, this assumption is, however, only supported by
small-scale qualitative research. There is no study in which this assumption
through quantitative research is confirmed.
Study objective
The assumptions of the traumatic effects of coercive measures as described in
the literature will be examined in the present study. The research questions
are how coercive measures are experienced by patients, to what extent these
measures are associated with PTSD symptoms in intensity, frequency and possible
diagnosis, and to what extent there is a relationship between these symptoms
and coping strategies used by the patient during admission. In addition, other
potentially traumatic experiences during admission will be inventarised. The
coercive measures to be studied are (1) the stay on a closed ward and stay in a
seclusion room (with or without forced medication during seclusion), (2) the
stay on a closed ward and only forced medication, (3) the stay on a closed
section without additional coercive measure (s). The results of this study
provide the basis for improving the quality of care in mental health care.
Study design
Observational research will be conducted to answer the research questions. At
three closed admission wards of the Parnassia Group 318 patients will be
questioned about their experiences during the coercive measures (Coercion
Experience Scale, CES) and will be mapped to what extent they suffer from PTSD
symptoms (Clinician-Administered PTSD Scale, CAPS). Other traumatic events
(Psychiatric Experiences Questionnaire, PEQ) and coping strategies (English
Letter Coping Strategy Indicator, DuBriSCI) during admission will be identified
by using two additional questionnaires. Per coercive measure, 106 patients will
be included in the study.
Study burden and risks
Patients will be asked to participate in the research right after they are
recovered from the crisis phase. After they have approved participation in the
research, they will be interviewd. The interview includes four questionnaires
and will take about one and a half hour.
This study provides insight into the experiences of patients regarding obtained
coercive measures during the present admission and the potentially adverse
effects of these measures for them. The participating patients have no direct
benefit from participation in the study. The results of this study may
contribute to an improvement of the quality of care and treatment for this
patient group in the longterm.
The principal psychiatrist of the largest closed ward of Mental Health Care in
the Netherlands, being one of the main research sites of this study, is
consulted in order to assess the feasibility of the research. The duration of
the interview as well as the subjects that will be questioned are not expected
to be an obstacle for the data gathering. Similar research in this department
shows great willingness of patients to tell about their experiences during
admission. The main researcher has identical experiences from similar research
at a similar study population.
Patients will be refered to their psychiatrist for special treatment if the
interview shows evidence of severe PTSD symptoms and if patients agree to this
reference. When patients refuse this reference they will be advised to contact
their psychiatrist themselves.
Kiwistraat 32
Den Haag 2552 DH
NL
Kiwistraat 32
Den Haag 2552 DH
NL
Age
Inclusion criteria
Admitted patients of closed acute admission ward in a psychiatric hospital
Patients who experienced one of the test coercive measure during admission
Crisis is in remission
Age above 18
Good skills in reading an speaking dutch
Exclusion criteria
Patients who don't understand the Dutch language
Patients who are unable to participate in the study due to their mental state
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL39420.058.13 |