دورية أكاديمية
أعرض في EDS

Comparing attitudes towards compulsory interventions in severe and persistent mental illness among psychiatrists in India and Switzerland.

التفاصيل البيبلوغرافية
العنوان: Comparing attitudes towards compulsory interventions in severe and persistent mental illness among psychiatrists in India and Switzerland.
المؤلفون: Rickli C; Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland., Stoll J; Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland., Westermair AL; Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland.; Clinical Ethics Unit, University Hospital Basel (USB) and University Psychiatric Clinics (UPK) Basel, Basel, Switzerland., Trachsel M; Clinical Ethics Unit, University Hospital Basel (USB) and University Psychiatric Clinics (UPK) Basel, Basel, Switzerland. manuel.trachsel@usb.ch.; Faculty of Medicine, University of Basel, Basel, Switzerland. manuel.trachsel@usb.ch.
المصدر: BMC psychiatry [BMC Psychiatry] 2024 Apr 18; Vol. 24 (1), pp. 295. Date of Electronic Publication: 2024 Apr 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Mental Disorders*/therapy , Mental Disorders*/psychology , Psychiatrists*, Humans ; Chronic Disease ; India ; Quality of Life ; Switzerland
مستخلص: Background: Psychiatrists face a major ethical challenge when deciding whether to make use of coercive measures in the treatment process of patients suffering from severe and persistent mental illness (SPMI). As India and Switzerland show major cultural, political and financial differences, it is hypothesized that attitudes towards coercive measures among Indian and Swiss psychiatrists will vary too. Exploring differences in attitudes between cultures strengthens the critical reflection on one's own stances and in consequence, on our way of action. Especially when it comes to situations involving power imbalances between patients and health practitioners, self-reflection is essential to prevent ethically inappropriate behavior.
Methods: An online survey on aspects of care for patients with SPMI was sent to 3'056 members of the Indian Psychiatric Society between April and June 2020 and to 1'311 members of the Swiss Society for Psychiatry and Psychotherapy between February and March 2016. The respondents' answers were compared. This article deals with the questionnaire's items on autonomous decision making and the implementation of coercive measures in clinical practice. More precisely, participating psychiatrists were asked to rate the importance of patient's autonomy in general and their willingness to apply coercive measures regarding two specific case vignettes depicting a patient with schizophrenia and one with depression. The statistical analysis, namely descriptive data analysis and calculation of arithmetic means, Shapiro Wilks tests and Mann-Whitney U tests, was carried out using IBM SPSS Statistics version 27.
Results: Answers were received from 206 psychiatrists in India and 457 psychiatrists in Switzerland. Indian participants tended to value autonomous decision making as slightly less important than Swiss participants (62.2% vs. 91%, p =.01). Regarding a case of severe and persistent depression, psychiatrists in the Indian group were on average more in favor of acting against the wishes of the patient (55% vs. 34.1%, p <.0001) as well as of accepting a temporary decrease in quality of life due to coercion (40% vs. 23%, p =.008). Answers concerning a case of schizophrenia revealed that Indian participants were more in favor of acting against the patient's wishes than Swiss participants (39% vs. 37%, p =.007), whereas the comparison whether to accept a temporary decrease in quality of life regarding this case showed no significant difference (p =.328).
Conclusions: The significant difference in attitudes towards coercive measures among Indian compared to Swiss psychiatrists found in this study might arise from a predominantly more collectivist society in India compared to Switzerland. Moreover, differences in financial resources, the organization of the health care system, and the historical background might have an influence. Continuous and critical reflection on one's own views and behavior is essential, especially if ethical principles and individual rights could be violated through a power imbalance, as in the case of coercive measures.
(© 2024. The Author(s).)
References: Schizophr Bull. 1990;16(4):551-61. (PMID: 1981813)
Indian J Psychiatry. 2001 Oct;43(4):293-4. (PMID: 21407876)
Psychiatr Serv. 2010 Oct;61(10):1012-7. (PMID: 20889640)
Front Psychiatry. 2021 May 25;12:537379. (PMID: 34113265)
Indian J Psychiatry. 2010 Apr;52(2):113-26. (PMID: 20838498)
Indian J Psychiatry. 2019 Apr;61(Suppl 4):S816-S820. (PMID: 31040480)
Indian J Psychiatry. 2016 Dec;58(Suppl 2):S221-S229. (PMID: 28216773)
Psychiatry Res. 2012 Dec 30;200(2-3):939-44. (PMID: 22575342)
Front Psychiatry. 2020 Jul 06;11:648. (PMID: 32733295)
Indian J Psychiatry. 2010 Jul;52(3):203-6. (PMID: 21180403)
Swiss Med Wkly. 2018 Apr 26;148:w14616. (PMID: 29698543)
Int Psychiatry. 2009 Jul 01;6(3):64-66. (PMID: 31507996)
Front Psychiatry. 2022 May 26;13:858699. (PMID: 35693967)
Indian J Psychiatry. 2019 Apr;61(Suppl 4):S660-S666. (PMID: 31040454)
J Pers Soc Psychol. 2003 Jan;84(1):97-110. (PMID: 12518973)
Int Rev Psychiatry. 2004 Feb-May;16(1-2):126-41. (PMID: 15276945)
Eur Psychiatry. 2004 Apr;19(2):91-5. (PMID: 15051108)
Front Psychiatry. 2019 Nov 06;10:783. (PMID: 31780962)
BMC Psychiatry. 2019 Apr 11;19(1):111. (PMID: 30975122)
Schizophr Bull. 2002;28(3):531-5. (PMID: 12645684)
Nervenarzt. 2019 Jul;90(7):669-674. (PMID: 31073675)
Crit Radic Soc Work. 2014 Aug 1;2(2):235-249. (PMID: 25984302)
Am J Psychiatry. 2013 Sep;170(9):1059-61. (PMID: 24030616)
Br J Psychiatry. 2014 Jan;204(1):1-2. (PMID: 24385456)
Indian J Psychiatry. 2019 Apr;61(Suppl 4):S776-S781. (PMID: 31040473)
Indian J Psychiatry. 2019 Mar-Apr;61(2):151-155. (PMID: 30992609)
Indian J Psychiatry. 2009 Jul-Sep;51(3):199-201. (PMID: 19881048)
Clin Ethics. 2017 Sep;12(3):150-165. (PMID: 28989327)
Am Psychol. 2000 Jan;55(1):79-88. (PMID: 11392868)
Br J Psychiatry. 2000 Aug;177:149-55. (PMID: 11026955)
J Am Acad Psychiatry Law. 2002;30(1):136-44. (PMID: 11931362)
Int J Law Psychiatry. 2021 Jan-Feb;74:101665. (PMID: 33401095)
Indian J Psychiatry. 2013 Jul;55(3):216-9. (PMID: 24082240)
Indian J Psychiatry. 2012 Jul;54(3):257-65. (PMID: 23226851)
Med Health Care Philos. 2018 Dec;21(4):467-477. (PMID: 29243015)
Asian J Psychiatr. 2014 Apr;8:2-6. (PMID: 24655618)
Psychol Bull. 1992 Jul;112(1):155-9. (PMID: 19565683)
فهرسة مساهمة: Keywords: Autonomy; Coercion; Depression; India; Psychiatrists; Schizophrenia; Switzerland
تواريخ الأحداث: Date Created: 20240418 Date Completed: 20240422 Latest Revision: 20240618
رمز التحديث: 20240619
مُعرف محوري في PubMed: PMC11025243
DOI: 10.1186/s12888-024-05710-6
PMID: 38637747
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-244X
DOI:10.1186/s12888-024-05710-6