Variation in opinions on coercion use among mental healthcare professionals: a questionnaire study

Figures & data

Table 1. Respondent and non-respondent characteristics (N = 601).

		Respondents	Non-respondents	p-value
		N = 132	N = 469
Gender	Female	93 (70.5%)	372 (79.3%)	.032
	Male	39 (29.5%)	97 (20.7%)
Age groups	<36 year	24 (18.2%)	138 (29.4%)	<.001
	36–50 year	50 (37.9%)	142 (30.3%)
	>50 year	58 (43.9%)	136 (29.0%)
	Unknown	0 (0.0%)	53 (11.3%)
Years since graduation		11 (6–15)	9 (5–15)	.081
Education background	Medical	24 (18.2%)	111 (23.7%)	.19
	Nursing	97 (73.5%)	334 (71.2%)
	Pedagogical	11 (8.3%)	24 (5.1%)
Workplace	Hospital a	75 (56.8%)	175 (37.3%)	<.001
	Hospital b	40 (30.3%)	153 (32.6%)
	Hospital c	17 (12.9%)	141 (30.1%)
Mental health services branch	General psychiatry	64 (48.5%)
	Forensic psychiatry	68 (51.5%)
Years of experience in mental health services	0–4	34 (25.8%)
	5–9	32 (24.2%)
	10–19	33 (25.0%)
	+20	33 (25.0%)
Years of experience in forensic mental health care	0 years	53 (40.2%)
	1–4 years	32 (24.2%)
	5–9 years	23 (17.4%)
	+10 years	24 (18.2%)
Self-rated experience with coercion in psychiatry	Much experience	81 (61.4%)
	Some experience	40 (30.3%)
	Little or no experience	11 (8.3%)

Table 2. Respondent opinions regarding second scenario – in-hospital coercion use.

Management of situation illustrated in second scenario	n	Percentage
“I let the patient escape from the room with a view to subsequently resolve the situation outside the patient room”	50	38
“Together with the other staff members, I catch hold of the patient and hold the patient until the patient calms down completely and can be released”	41	31
“Together with the other staff members, I catch hold of the patient and put the patient in a belt”	13	10
“Together with the other staff members, I catch hold of the patient and administer a sedative injection”	29	22

Table 3. Unadjusted and adjusted odds ratios for respondent beliefs about colleagues’ willingness to use same level of coercion in second scenario (in-hospital coercion use).

		Unadjusted				Adjusted^‡
		OR	95% CI		p-value	OR	95% CI		p-value
Gender	Women	1,00				1,00
	Men	1,11	0,51	2,38	0,80	1,29	0,49	3,38	0,60
Age	<36 y	1,00				1,00
	36–50 y	0,77	0,29	2,07	0,61	0,57	0,17	1,96	0,37
	>50 y	1,47	0,55	3,90	0,44	1,13	0,31	4,15	0,85
Education	Doctor	1,00				1,00
	Nurse	0,86	0,34	2,15	0,74	0,74	0,21	2,63	0,64
	Pedagogical	1,05	0,24	4,62	0,95	1,01	0,15	6,58	0,99
Workplace	Hospital a	1,00				1,00
	Hospital b	1,73	0,79	3,79	0,17	1,93	0,80	4,67	0,14
	Hospital c	16,00	2,02	126,93	0,01	19,17	2,29	162,07	0,01
Specialized in psychiatry	No	1,00				1,00
	Yes	0,42	0,19	0,90	0,03	0,29	0,10	0,82	0,02
Years of experience in mental health care	0–4	1,00				1,00
	5–9	1,15	0,43	3,07	0,77	1,71	0,52	5,70	0,38
	10–19	1,21	0,46	3,21	0,70	2,44	0,67	8,79	0,18
	+20	1,38	0,52	3,68	0,52	1,68	0,45	6,32	0,44
Self-rated experience with coercion in psychiatry	Much	1,00				1,00
	Some	0,93	0,43	2,00	0,85	0,93	0,36	2,39	0,88
	Little	1,83	0,45	7,43	0,40	1,60	0,29	9,12	0,60
Preferring coercive intervention	No	1,00				1,00
	Yes	2,90	1,40	6,02	<0,01	2,60	1,14	5,94	0,02

OR = Odds ratio, y = years. Bold font indicates statistical significance. ^‡Hosmer-Lemeshow goodness-of-fit, chi² = 2.04.

Table 4. Unadjusted and adjusted odds ratios for coercion use in scenario 1 about involuntary admission and in scenario 2 about use of coercion during an in-hospital stay.

	Scenario 1 (involuntary admission)								Scenario 2 (in-hospital coercion use)
	Unadjusted				Adjusted^†				Unadjusted				Adjusted^‡
	OR	95% CI		p-value	OR	95% CI		p-value	OR	95% CI		p-value	OR	95% CI		p-value
Gender
Female	1.00				1.00				1.00				1.00
Male	0.73	0.34	1.54	0.41	0.29	0.11	0.78	0.01	0.97	0.45	2.08	0.93	0.91	0.36	2.27	0.84
Age
<36 year	1.00				1.00				1.00				1.00
36–50 year	0.84	0.31	2.24	0.73	1.27	0.38	4.22	0.69	0.36	0.12	1.06	0.06	0.32	0.09	1.09	0.07
>50 year	1.01	0.39	2.66	0.98	1.41	0.41	4.88	0.59	0.63	0.22	1.85	0.40	0.56	0.16	2.02	0.38
Education
Medical	1.00				1.00				1.00				1.00
Nursing	0.37	0.14	1.01	0.05	0.18	0.05	0.65	0.01	0.59	0.22	1.55	0.28	0.47	0.14	1.62	0.24
Pedagogical	0.40	0.09	1.80	0.23	0.23	0.04	1.47	0.12	1.10	0.22	5.40	0.91	1.16	0.18	7.63	0.88
Workplace
Hospital a	1.00				1.00				1.00				1.00
Hospital b	2.29	1.02	5.16	0.05	2.82	1.11	7.13	0.03	1.18	0.54	2.60	0.68	1.40	0.59	3.32	0.45
Hospital c	0.84	0.29	2.42	0.75	0.63	0.19	2.02	0.43	1.64	0.52	5.13	0.40	1.74	0.52	5.83	0.37
Specialized in psychiatry
No	1.00				1.00				1.00				1.00
Yes	1.24	0.58	2.67	0.58	0.57	0.21	1.55	0.27	0.78	0.36	1.68	0.52	0.57	0.21	1.54	0.27
Years of experience in mental health care
0–4	1.00				1.00				1.00				1.00
5–9	1.14	0.43	3.02	0.79	0.91	0.29	2.84	0.87	1.34	0.49	3.63	0.57	1.37	0.44	4.28	0.58
10–19	1.21	0.46	3.16	0.70	0.76	0.22	2.66	0.67	1.08	0.41	2.86	0.88	1.37	0.40	4.70	0.62
+20	1.37	0.52	3.61	0.53	0.78	0.21	2.94	0.72	1.23	0.46	3.28	0.69	1.23	0.34	4.44	0.76
Self-rated experience with coercion in psychiatry
Much experience	1.00				1.00				1.00				1.00
Some experience	0.53	0.25	1.15	0.11	0.35	0.14	0.92	0.03	0.84	0.38	1.82	0.65	0.83	0.33	2.07	0.68
Little or no experience	0.49	0.14	1.74	0.27	0.19	0.04	0.94	0.04	0.67	0.19	2.38	0.54	0.52	0.11	2.46	0.41

OR = Odds ratio, y = years. Bold font indicates statistical significance. ^‡Hosmer-Lemeshow goodness-of-fit, chi2 = 6.52. ^†Hosmer-Lemeshow goodness-of-fit, chi2 = 7.01.

Data availability statement

Data are available from the author upon reasonable request.