1
|
Linkhorst T, Birkeland SF, Gildberg FA, Mainz J, Torp-Pedersen C, Bøggild H. Use of the least intrusive coercion at Danish psychiatric wards: A register-based cohort study of 131,632 first and subsequent coercive episodes within 35,812 admissions. Int J Law Psychiatry 2022; 85:101838. [PMID: 36208564 DOI: 10.1016/j.ijlp.2022.101838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Psychiatric legislation in Denmark implies a principle of using the least intrusive types of coercion first. The intrusiveness is not universally agreed upon. We examined the order in which coercive measures during admission were used, implying that the first used should be less intrusive than the following types. METHODS For coercive episodes reported to the national administrative register for the period 2011-16, the order of 12 legal coercive interventions during each admission was examined. Comparing with mechanical restraint, the odds ratio (OR) and confidence interval (95%CI) of being first or subsequent used types were estimated using conditioned (96,611 episodes) and unconditioned (131,632 episodes) logistic regression models, stratified on sex. RESULTS Totally 17,796 patients aged 18+ were subjected to at least one coercive episode. The median time between admission and the first episode was 4 days in men and 6 for women. For females, involuntary detention, forced feeding, coercive treatment of somatic disorder, locking of doors and close observations in females were used before mechanical restraint, and forced follow-up, involuntary electro convulsive therapy (ECT), forced treatment, use of gloves and straps, physical restraint and forced intramuscular medication was used later. In men, only involuntary detention was used before mechanical restraint, while involuntary ECT, close observations, administration of drugs, use of gloves and straps, physical restraint and forced intramuscular medication was used after mechanical restraint. CONCLUSION The order of used coercive measures is not consistent with the international ranking of the least intrusive types, especially in men and in younger adults.
Collapse
Affiliation(s)
- Thea Linkhorst
- Odense University Hospital, Region of Southern Denmark, 5000 Odense, Denmark; Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, 5500 Middelfart, Denmark
| | | | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, 5500 Middelfart, Denmark; Department of Psychiatry, Middelfart, Mental Health Services, Region of Southern Denmark, 5500 Middelfart, Denmark.
| | - Jan Mainz
- Department of Psychiatry, North Denmark Region, 9000 Aalborg, Denmark; Danish Center for Clinical Health Services Research (DACS), Aalborg University Hospital, Aalborg University, 9000 Aalborg, Denmark; Department of Community Mental Health, University of Haifa, Mount Carmel, Haifa, Israel; DaCHE, University of Southern Denmark, 5000 Odense, Denmark.
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark; Department of Cardiology, Nordsjællands Hospital, 3400 Hillerød, Denmark; Department of Public Health, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Henrik Bøggild
- Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, E, Denmark; Unit of Clinical Biostatistics, Aalborg University Hospital, 9000 Aalborg, Denmark.
| |
Collapse
|
2
|
Birkeland S, Linkhorst T, Haakonsson A, Barry MJ, Möller S. Representativeness of personality and involvement preferences in a web-based survey on healthcare decision-making. BMC Health Serv Res 2020; 20:851. [PMID: 32912191 PMCID: PMC7488239 DOI: 10.1186/s12913-020-05717-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background Obtaining a sample that is representative of the group of interest is of utmost importance in questionnaire studies. In a survey using a state authorized web-portal for citizen communication with authorities, we wanted to investigate the view of adult men on patient involvement in health care decision-making regarding Prostate-Specific Antigen test for prostatic cancer. In this paper, we report on sample characteristics and representativeness of our sample in terms of personality and baseline involvement preferences. Methods We compared personality profiles (BFI-10) and baseline healthcare decision-making preferences (CPS) in our sample (n = 6756) to internationally available datasets. Pooled data from a) US, UK, Canada, Australia, and New Zealand (n = 1512), b) Germany, Netherlands, Switzerland, and Belgium (n = 1136), and c) Norway, Sweden, Finland, and Denmark (n = 1313) were used for BFI-10 comparisons. Regarding CPS, we compared our sample with three previous datasets relating to decision-making in cancer (n = 425, 387, and 199). Results Although statistically significant differences particularly appeared in large dataset comparisons, sample BFI-10 and CPS profiles mostly were within the range of those previously reported. Similarity was greatest in BFI-10 comparisons with group a) where no statistically significant difference could be established in factors ‘agreeableness’ and ‘neuroticism’ (p = .095 and .578, respectively). Conclusion Despite some variation, our sample displays personality and baseline preference profiles that are generally similar to those described in previous international studies. For example, this was the case with the BFI-10 ‘agreeableness’ measure (incl. trust and fault-finding items), an important factor in healthcare decision-making.
Collapse
Affiliation(s)
- Søren Birkeland
- Department of Clinical Research, University of Southern Denmark and Open Patient data Explorative Network, Odense University Hospital, J. B. Winsløws Vej 9 a, 3. floor, DK-5000, Odense C, Denmark.
| | - Thea Linkhorst
- Department of Clinical Research, University of Southern Denmark and Open Patient data Explorative Network, Odense University Hospital, J. B. Winsløws Vej 9 a, 3. floor, DK-5000, Odense C, Denmark
| | - Anders Haakonsson
- Department of Clinical Research, University of Southern Denmark and Open Patient data Explorative Network, Odense University Hospital, J. B. Winsløws Vej 9 a, 3. floor, DK-5000, Odense C, Denmark
| | - Michael John Barry
- MGH Division of General Internal Medicine & Harvard Medical School, Boston, USA
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark and Open Patient data Explorative Network, Odense University Hospital, J. B. Winsløws Vej 9 a, 3. floor, DK-5000, Odense C, Denmark
| |
Collapse
|