Examining the Association Between Perceived Quality of Care and Experienced Coercion Among Patients in Acute Mental Health Units in Spain: A National Cross-Sectional Study.
Khadija El-Abidi, Sara Sanchez-Balcells, Juan F Roldán-Merino and 18 others
PMID 40707397WHAT IT FOUND
Patients who rated care quality lower, especially regarding privacy and safety, reported higher feelings of coercion and humiliation.
Improving environmental dignity and clear discharge planning is associated with reduced perceived coercion in acute mental health units.
Key findings
01Higher overall perceived quality of care was inversely associated with experiences of coercion and humiliation.
02The 'secluded environment' dimension, relating to privacy and dignity, showed the strongest association with reduced coercion and humiliation.
03Number of mechanical restraint episodes was significantly associated with perceived humiliation, coercion, and fear.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design means causality cannot be established; it is unclear if poor care leads to feelings of coercion or if patients feeling coerced rate care poorly. Exclusion of patients under mechanical restraint at the time of recruitment may bias results toward those less severely affected or more able to consent. Self-reported data on coercion and quality may be subject to social desirability bias, although anonymity was maintained.
Declared interests
The authors declare no conflicts of interest. Funding was provided by the Instituto de Salud Carlos III and the College of Nurses of Barcelona.
The easy way to misread this
Do not assume that improving care quality directly reduces the use of coercive measures like restraint. This study shows an association between how patients *perceive* the quality of care and how *coerced* they feel, not that better care leads to fewer actual coercive events.