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Persuasion or coercion? An empirical ethics analysis about the use of influence strategies in mental health community care
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Valenti, Emanuele and Giacco, Domenico (2022) Persuasion or coercion? An empirical ethics analysis about the use of influence strategies in mental health community care. BMC Health Services Research, 22 (1). 1273. doi:10.1186/s12913-022-08555-5 ISSN 1472-6963.
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WRAP-Persuasion-or-coercion-An-empirical-ethics-analysis-about-the-use-of-influence-strategies-in-mental-health-community-care-Giacco-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1233Kb) | Preview |
Official URL: https://doi.org/10.1186/s12913-022-08555-5
Abstract
Background: Influence strategies such as persuasion and interpersonal leverage are used in mental health care to influence patient behaviour and improve treatment adherence. One ethical concern about using such strategies is that they may constitute coercive behaviour ("informal coercion") and negatively impact patient satisfaction and the quality of care. However, some influence strategies may affect patients' perceptions, so an umbrella definition of “informal coercion” may be unsatisfactory. Furthermore, previous research indicates that professionals also perceive dissonance between theoretical explanations of informal coercion and their behaviours in clinical practice. This study analysed mental health professionals’ (MHPs) views and the perceived ethical implications of influence strategies in community care.
Methods: Qualitative secondary data analysis of a focus group study was used to explore the conflict between theoretical definitions and MHPs’ experiences concerning the coerciveness of influence strategies. Thirty-six focus groups were conducted in the main study, with 227 MHPs from nine countries participating.
Results: The findings indicate that not all the influence strategies discussed with participants can be defined as “informal coercion”, but they become coercive when they imply the use of a lever, have the format of a conditional offer and when the therapeutic proposal is not a patient’s free choice but is driven by professionals. MHPs are rarely aware of these tensions within their everyday practice; consequently, it is possible that coercive practices are inadvertently being used, with no standard regarding their application. Our findings suggest that levers and the type of leverage used in communications with the patient are also relevant to differentiating leveraged and non-leveraged influence.
Conclusion: Our findings may help mental health professionals working in community care to identify and discuss influence strategies that may lead to unintended coercive practices.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Mental health services , Managed mental health care, Patient compliance , Mental health personnel and patient, Involuntary treatment | ||||||
| Journal or Publication Title: | BMC Health Services Research | ||||||
| Publisher: | Biomed central | ||||||
| ISSN: | 1472-6963 | ||||||
| Official Date: | 21 October 2022 | ||||||
| Dates: |
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| Volume: | 22 | ||||||
| Number: | 1 | ||||||
| Number of Pages: | 15 | ||||||
| Article Number: | 1273 | ||||||
| DOI: | 10.1186/s12913-022-08555-5 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 12 December 2022 | ||||||
| Date of first compliant Open Access: | 12 December 2022 | ||||||
| RIOXX Funder/Project Grant: |
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