Patient's attitudinal changes regarding the need of hospitalization

Objective: It is reported that patients who refuse hospitalization at the time it is offered are likely to change their belief about the necessity of hospitalization after receiving hospital treatment. In the present research conducted at the 3rd Acute Psychiatric Ward of the Psychiatric Hospital of Thessaloniki, the authors examine how patients change their evaluations of psychiatric hospitalization following hospital treatment.

Method: The following factors are assessed: a) the need for hospitalization, b) the perceived coercion, c) the pressures, d) the procedural justice, e) the emotional status of 65 patients admitted in the hospital. These patients are interviewed at follow-up.

Results: Patients are subdivided into two groups: a) patients who believed they needed hospitalization and b) patients who believed they did not need hospitalization Changes in the patients' views and factors associated with these changes such as sex, legal status of admission, drug abuse, primary diagnosis, perception of illness are examined. Eighty per cent of the patients who at admission refused hospitalization changed their views. Only a single case that at admission accepted the need of hospitalization revised his belief. Twenty per cent of the patients still insisted that they had not needed hospitalization. This latter group is statistically differentiated in a significant degree by lower perception of illness, higher perceived coercion, lower sense of justice and higher feeling of anger. Seventy per cent of the patients who insisted that they had not needed hospitalization had a diagnosis of schizophrenia, in contrast to the first group, where only 43.3% of the patients were diagnosed as schizophrenics.

Conclusions: Many patients changed their views about hospitalization, however perceptions of coercion remained stable in a large number of them. Looking back on their hospitalization, coerced patients are likely to harbor feelings of offence, even when they have come to regard hospitalization as a necessity.