가족과 전문가로부터의 강요경험이 정신장애인의 회복태도에 미치는 영향에 관한 연구
A Study on Effects of Coercion by Family and Experts on the Recovery Attitude of the Persons with Mental Illness
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Objectives Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. Methods The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, de-pending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. Results When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. Conclusion The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.
Abstract
ObjectivesZZBased on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. MethodsZZThe participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, de-pending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. ResultsZZWhen socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. ConclusionZZThe findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.
참고문헌 (39)
- Swartz MS, "Can involuntary outpatient commitment reduce hospital recidivism?: Findings from a randomized trial with severely mentally ill individuals", Am J Psychiatry, 156, pp.1968~1975 (1999)
- Swanson JW, "Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness", Br J Psychiatry, 176, pp.324~331 (2000)
- Stone A, "Mental Health and Law: A System of Transition" (1975), Washington, DC; US Government Printing Office
- McEvoy JP, "Measuring chronic schizophrenic patients attitudes toward their illness and treatment", Hosp Community Psychiaty, 32, pp.856~858 (1981)
- Chien WT, "Psychiatric inpatients’ perceptions of positive and negative aspects of physical restraint", Patient Educ Couns, 59, pp.80~86 (2005)
- Lidz CW, "Factual sources of psychiatric patients’ perceptions of coercion in the hospital admission process", Am J Psychiatry, 155, pp.1254~1260 (1998)
- Kaltiala-Heino R, "Impact of coercion on treatment outcome", Int J Law Psychiatry, 20, pp.311~322 (1997)
- Wynn R, "Psychiatric patients’ experiences with restraint", J Forensic Psychiatry Psychology, 15, pp.124~144 (2004)
- Swanson JW, "Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness", Behav Sci Law, 21, pp.473~491 (2003)
- Rogers A, "Coercion and voluntary admission: an examination of psychiatric patient views", Behav Sci Law, 11, pp.259~267 (1993)
- Watts J, "A phenomenological account of users’ experiences of assertive community treatment", Bioethics, 16, pp.439~454 (2002)
- Wynn R, "Coercion in psychiatric care: clinical, legal, and ethical controversies", Int J psychiatry Clin Pract, 10, pp.247~251 (2006)
- Lindsey KP, "Involuntary commitments to public mental institutions : issues involving the overrepresentation of blacks and assessment of relevant functioning", Psychol Bull, 106, pp.171~183 (1989)
- Swartz MS, "Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals", Behav Sci Law, 21, pp.459~472 (2003)
- WHO, "Principles for the protection of persons with mental illness and the improvement of mental health care" (2001)
- 김춘진, "정신보건정책의 문제점과 해결방안" (2007), 국정감사 정책자료집
- 국가인권위원회, "지방자치단체의 정신보건업무 수행실태조사" (2006)
- Na YH, "Mental health facilities and human rights", 2008 Spring Conference of the Korea Academy of Mental health Social Work (2008)
- 서미경, "정신보건시설에서의 정신장애인 권리침해에 관한 연구 - 국가인권위원회 진정사례를 중심으로 -", 정신보건과 사회사업, (29), pp.330~367 (2008), 한국정신보건사회복지학회
- Monahan J, "Coercion to inpatient treatment: Initial results and implications for assertive treatment in the community. In Coercion and Aggressive Community Treatment: A new Frontier in Mental Health Law", pp.13~28 (1996), Plenum Press
- Lidz CW, "Sources of coercive behaviours in psychiatric admissions", Acta Psychiatr Scand, 101, pp.73~79 (2000)
- Swartz MS, "The perceived coerciveness of involuntary outpatient commitment: findings from an experimental study", J Am Acad Psychiaty Law, 30, pp.207~217 (2002)
- Bae JK, "Attitude of recovery and quality of life of persons with psychiatric disabilities-Focused on scale development and model testing" (2004), Daegu: Keimyung Univ
- Kahang SK, "Psychological Factors Involved in the Operation of Mental Illness Stigma-Implications for Practice and Policy" (2002), The University of Michigan
- Cascardi M, "Correlates of perceived coercion during psychiatric hospital admission", Int J Law Psychiatry, 20, pp.445~458 (1997)
- McKenna BG, "Outpatient commitment and coercion in New Zealand: a matched comparison study", Int J Law Psychiatry, 29, pp.145~115 (2006)
- Seo MK, "Mental Illness and Family", pp.84~ (2007), Paju, Gyeonggi do. Jipmoondang
- Viinamäki H, "Factors predicting psychosocial recovery in psychiatric patients", Acta Psychiatr Scand, 94, pp.365~371 (1996)
- Liberman RP, "Operational criteria and factors related to recovery from schizophrenia", Int Rev Psychiatry, 14, pp.256~272 (2002)
- Torgalsbøen AK, "Full recovery from schizophrenia in the long term: a ten-year follow-up of eight former schizophrenic patients", Psychiatry, 61, pp.20~34 (1998)
- 황숙연, "정신장애인의 회복의 인식에 관한 탐색적 고찰", 정신보건과 사회사업, (27), pp.28~63 (2007), 한국정신보건사회복지학회
- 최윤정, "정신장애인의 회복 태도와 이에 영향을 미치는 요인에 관한 연구", 정신보건과 사회사업, (26), pp.111~143 (2007), 한국정신보건사회복지학회
- Kelly M, "Exploring the concept of recovery in schizophrenia", J Psychiatr Ment Health Nurs, 12, pp.245~251 (2005)
- Roe D, "Patients’ and staff members’ attitudes about the rights of hospitalized psychiatric patients", Psychiatr Serv, 53, pp.87~91 (2002)
- Kane JM, "Attitudinal changes of involuntarily committed patients following treatment", Arch Gen Psychiatry, 40, pp.374~337 (1983)
- Seo DW, "Mental health policy and law in Korea", Health and Welfare policy Forum, 통권 : 123, pp.42~56 (2007)
- Beauchamp TL, "Principles of Biomedical Ethics", pp.164~ (1994), Oxford University Press