Coercion and treatment satisfaction among involuntary patients.
OBJECTIVE
This study aimed to assess involuntary inpatients' satisfaction with treatment and explore how coercion and other factors are associated with satisfaction.


METHODS
An observational prospective study was conducted in 67 acute wards in 22 hospitals in England. A total of 778 involuntary inpatients were recruited, and their satisfaction with treatment was assessed a week after admission and at the one-month, three-month, and one-year follow-ups. Perceived and documented coercion at admission and during hospital treatment, sociodemographic and clinical characteristics, and clinical improvement were tested as potential predictors of satisfaction.


RESULTS
Mean scores on the Client's Assessment of Treatment Scale measuring satisfaction with treatment ranged from 5.5 to 6.0 (on a scale with possible scores ranging from 0 to 10) at different time points and improved significantly from admission to the follow-ups. Patients who perceived less coercion at admission and during hospital treatment were more satisfied overall, whereas coercive measures documented in the medical records were not linked to satisfaction. Patients with more symptom improvement expressed higher levels of treatment satisfaction.


CONCLUSIONS
Satisfaction with treatment among involuntary patients was associated with perceptions of coercion during admission and treatment, rather than with the documented extent of coercive measures. Interventions to reduce patients' perceived coercion might increase overall treatment satisfaction.
Katsakou
Christina
C
Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, Glen Rd., London E138SP, United Kingdom. c.katsakou@qmul.ac.uk
Bowers
Len
L
Amos
Tim
T
Morriss
Richard
R
Rose
Diana
D
Wykes
Til
T
Priebe
Stefan
S
D000328:Adult; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019370:Observation; D017060:Patient Satisfaction; D011446:Prospective Studies