Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


akron1144851107.pdf (4.24 MB)

ETD Abstract Container

Abstract Header

COMPARISON OF HEALTH CARE CONTEXT, COERCION, AND COMPLIANCE IN PERSONS WITH SEVERE AND PERSISTENT MENTAL ILLNESS

Galon, Patricia Ann
http://rave.ohiolink.edu/etdc/view?acc_num=akron1144851107

Abstract Details

2006, Doctor of Philosophy, University of Akron, Nursing.
Persons with severe and persistent mental illness (SPMI) who do not participate in treatment, use disproportionate amounts of high intensity services, have co-occurring substance abuse disorders, and have frequent contact with the criminal justice system. Clinical management of this population may be enhanced by the use of coercive treatment including Assertive Community Treatment (ACT) and outpatient commitment (OPC). Previous research implicates procedural justice (giving the client voice during legal/treatment proceedings) as mediating the relationship between ACT/OPC and the perception of coercion, which then influences other outcomes including treatment compliance, violence/victimization, rehospitalization, and quality of life. The purpose of this research was to examine the influence of the legal context of care and treatment modalities that vary in degree of coercion on the client’s perception of procedural justice and coercion, compliance with treatment, and other outcomes. The random sample included 154 adults with SPMI. This study compared OPC/ACT to evaluate the effects individually and in combination on mediating and outcome variables. The research was constructed as a quasi experiment using a 2 x 2 factorial design. Type of treatment (ACT versus Usual Care) was crossed with Outpatient Commitment Status (OPC versus no OPC). ANOVA and multiple regression procedures were used to test hypotheses. Correlations and part correlations were used to examine relationships among key variables. Findings supported that the perception of procedural justice/choice and the perception of coercion/negative pressure were inversely related. Also, procedural justice/choice, OPC status, and race were significant predictors of the perception of coercion. The bivariate relationship between procedural justice and perception of coercion was stronger for whites than for non-whites. A portion of the model was tested and confirmed a direct relationship between OPC and the perception of coercion/negative pressure and an indirect relationship between these variables through procedural justice/choice. Examination of this model for whites and non-whites separately revealed that the direct relationship between OPC and perception of coercion/negative pressure was only upheld for white subjects. Suggestions for further research, implications for clinical practice, and health care policy are delineated.
Margaret Wineman (Advisor)
173 p.
Coercion; Outpatient commitment; Assertive community treatment

Recommended Citations

Citations

  • Galon, P. A. (2006). COMPARISON OF HEALTH CARE CONTEXT, COERCION, AND COMPLIANCE IN PERSONS WITH SEVERE AND PERSISTENT MENTAL ILLNESS [Doctoral dissertation, University of Akron]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=akron1144851107

    APA Style (7th edition)

  • Galon, Patricia. COMPARISON OF HEALTH CARE CONTEXT, COERCION, AND COMPLIANCE IN PERSONS WITH SEVERE AND PERSISTENT MENTAL ILLNESS. 2006. University of Akron, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=akron1144851107.

    MLA Style (8th edition)

  • Galon, Patricia. "COMPARISON OF HEALTH CARE CONTEXT, COERCION, AND COMPLIANCE IN PERSONS WITH SEVERE AND PERSISTENT MENTAL ILLNESS." Doctoral dissertation, University of Akron, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=akron1144851107

    Chicago Manual of Style (17th edition)

akron1144851107
1,990
© 2006, all rights reserved.
This open access ETD is published by University of Akron and OhioLINK.