The Study Of Subjective Experience In Involuntary Inpatients With Mental Disorders

ObjectiveThe relative foreign scales of subjective experience in involuntary inpatients were collected,translated,revised in this study.Reliability and validity of these scales were tested.A preliminary investigation on the experience of involuntary inpatients was carried out with the obtained scales.Methods1.Clients’ Scale for Assessment of Treatment(CAT),the Admission Experience Survey(AES)and the Coercion Experience Scale(CES)were collected,translated and revised.Reliability and validity of these scales were tested among psychiatric inpatients in clos-wards.2.A total of 241(male 49.8%,female 50.2%)involuntary inpatients were investigated.Basic condition questionnaire,Brief Psychiatric Rating Scale(BPRS)and basic attitude questionnaire were used to collect basic information of the subjects.CAT was used to evaluate treatments,CES was used to investigate coercion experience.Results 1.Part One(1)Test-retest reliability of CAT was 0.84(P<0.001),correlation among items were 0.53~0.91(P<0.001),and the 7 items explained 73.93% of the variance.(2)Test-retest reliability of AES were between 0.44~0.84(P<0.05),correlation among items were 0.28~0.59(P<0.01)in perceived coecion,0.18~0.57(P<0.01)in negative process and 0.08~0.33(P>0.05)in procedural exclusion.The three factors of AES explained 50.38% of the variance.(3)Test-retest reliability of CES were between 0.33~0.72(P<0.05),except item 5,9 and 27,of which test-retest reliability were statistically meaningless.correlations among items were 0.62~0.89(P<0.01)in restrictions of human rights,0.40~0.73(P <0.01)in passive,0.41~0.61(P <0.01)in negative pressures,0.49~0.67(P <0.01)in humiliation,0.49~0.57(P <0.01)in negative environment and 0.72(P <0.01)in fear.The 6 factors of CES explained 71.78% of all the variance.The parameter model of CES was acceptable(CMIN/DF=2.496,NFI=0.738,IFI=0.787,CFI=0.900,RMSEA=0.111).2.Part TwoThe scores of CAT(46.66±17.03)and CES(49.90±33.84)were negatively correlated(r=-0.49,P<0.001).The score of CAT was negatively correlated with scores of BPRS(r=-0.26,P<001),motor retardation(r=-0.22,P<0.01),thought disturbances(r=-0.16,P<0.05),activation(r=-0.20,P<0.01)and hostility and suspiciousness(r=-0.23,P<0.01)。The score of CES was positively correlated with scores of BPRS(r=-0.16,P<0.01),motor retardation(r=-0.17,P<0.01)and hostility and suspiciousness(r=-486,P<0.001).Multivariate regression analysis model could explain 17.5% variables of scores of CES.Within these independent factors,physical restriction(B=14.91,P=0.001),delivery person(police)(B=17.39,P=0.023),education(junior and below)(B=-19.04,P=0.001)and BPRS(hostility and suspiciousness)(B=2.65,P=0.023)had statistically significant affect to scores of CES.ConclusionThe reliability and validity of CAT were acceptable,therefore CAT was suitable to assess treatment among target groups.AES needed a further revision and reliability-validity test.Generally the reliability and validity of CES were acceptable,except the test-retest reliability among 3 items.Thus CES was suitable to assess coercive experience among patients with mental disorders.For involuntary inpatients,less coercion they perceived,and lighter symptoms were correlated with higher evaluations of treatments.The severe level symptoms of motor retardation and hostility and suspiciousness were correlated with more coercion.Besides,their assessments for treatment was correlated with coercive experience.