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Coercive Measures and Stigmatization in the Psychiatric Medical Care

机译:精神科医疗中的强制措施和耻辱

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The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict.The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance.Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders.Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036).Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.
机译:精神病患者的非自愿承诺在487/2002的法律下几十年来,精神健康法律法律和精神疾病的人的保护。频繁的无意识精神病院导致耻辱态度和歧视性对精神障碍患者的行为。强制医疗措施适用于心理健康保护机构的精神科机构。胁迫在精神病学援助中产生了严重的道德辩论。在精神病院住院的人预计社会拒绝成为防守,撤回社会,经历一个复杂的内部冲突。本研究的目标是说明与强制措施相关的方面,在非自愿入场患者的矫正措施中的机械束缚精神病医疗援助。材料和方法:本研究是一个回顾性的,数据来自于2002年10月至2012年7月的非自愿招生的图表中获取。研究的批次由202名患者组成,在精神病院中不由自主地录取根据法律487/2002,精神病患者的心理健康和保护法。结果:25.7%的患者不由自主地录取,在入院期间需要强制措施,58%含有自我伤害等症状。在急性病例中患有症状为症状和/或他人的危害,尤其是症状的机械争用措施,也是幻觉 - 谵妄症状的情况。在住院期间需要矫顽措施的主题批量的男性性受试者的比例显着更高,这些措施不由自主地录取(86.5%与72%)(p = 0.036)。结论:在精神病学中,不自愿入场和强制性治疗,法律和道德问题。所需措施主要可以通过蔑视患者的自治,主要涉及临床福利,暗示精神病学专家的父亲态度。治疗顺应性与整体运作水平和与自我耻辱程度成反比成正比。

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