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

Sep 30, 2026

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Aim: Examine how perceived quality of care relates to the level of coercion experienced by individuals hospitalised in acute mental health units. Design: National cross-sectional study. Methods: Data from 255 patients across 12 acute mental health units in Spain; standardised instruments measured perceived quality and coercion, humiliation, and fear at discharge, analysed with multiple linear regression. Results: Higher perceived quality correlated with lower coercion and humiliation, with the “secluded” dimension strongest; fear associations were less consistent. Conclusion: Better perceived care quality aligns with reduced coercion, humiliation, and fear during hospitalisation.

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Journal of Clinical Nursing 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-Abidi1 | Sara Sanchez-Balcells1,2 | Juan F. Roldán-Merino3 | Ana Ventosa Ruiz1,2 | Montse Cañabate-Ros4,5 | Juan A. Garcia-Sanchez6 | Estibaliz Muñoz-Rouco7 | Juan J. Pérez-Moreno7 | Javier Pita-De-La-Vega8 | Gemma Rubia-Ruiz9 | Carolina Santos-Pariente10 | Ana Maria Rodríguez López11 | Laura Jardón Golmar12 | Cristina Esquinas López1 | Juan Gomez Perez13 | Marcelino Vicente Pastor-Bernabeu13,14 | Joana Coelho15,16 | Evdokia Misouridou17 | M. Teresa Lluch-Canut1,2 | Montserrat Puig-Llobet1,2 | Antonio R. Moreno-Poyato1,2 1Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain | 2Mental Health, Psychosocial and Complex Nursing Care Research Group—NURSEARCH, University of Barcelona, Barcelona, Spain | 3Mental Health Department, Campus Docent Sant Joan de Déu, Universitat de Vic-Universitat Central de Cataumya (UVIC-UCC), Sant Boi de Llobregat, Spain | 4Grupo de investigación MHG, San Vicente Mártir, Universidad Católica de Valencia, Valencia, Spain | 5Hospital Clínico Universitario de Valencia, Unidad de hospitalización de psiquiatría y toxicomanía, Valencia, Spain | 6Department of Mental Health, Biomedical Research Institute of Malaga (IBIMA), University General Hospital of Málaga, Málaga, Spain | 7Psychiatry Service, Osakidetza-Basque Health Service, Galdakao-Usansolo Hospital, Galdakao-Usansolo, Spain | 8Department of Mental Health, Children's Mental Health Centre, Consorci Sanitari del Maresme, Mataró, Spain | 9Hospital Infanta Leonor, Madrid, Spain | 10Hospital Virgen de los Lirios, Alcoy, Alicante, Spain | 11Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain | 12Hospital Alvaro Cunqueiro, Vigo, Spain | 13Departamento de Salud de Alicante, Sant Joan d'Alacant, Spain | 14Departamento de Enfermería de la Facultad de Ciencias de la Salud de la, Universidad de Alicante, Alicante, Spain | 15Northern Health Higher School of the Portuguese Red Cross, Oliveira de Azeméis, Portugal | 16RISE-Health, Nursing School of Porto (ESEP), Porto, Portugal | 17Department of Nursing, University of West Attica, Egaleo, Greece Correspondence: Sara Sanchez-Balcells ([sara.sanchez@ub.edu](sara.sanchez@ub.edu)) Received: 29 May 2025 | Revised: 30 June 2025 | Accepted: 11 July 2025 Funding: Funding was granted in 2021 by the Institute of Health Carlos III (PI21/00605, Ministry of Science and Innovation) and in October 2021 by the College of Nurses of Barcelona (PR-487/2021), after a peer-reviewed funding process. This project is also co-funded by the European Regional Development Fund (ERDF) . Keywords: coercion | fear | mental health services | patient satisfaction | quality of health care ABSTRACT Aim: To examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units. Design: National cross-sectional study. Methods: Data were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences. Results: Perceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the “secluded” dimension showing the strongest association. The This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original w

FAQs

What was the study aiming to investigate?

The study examined the association between perceived quality of care and the level of coercion experienced by patients hospitalised in acute mental health units.

How were perceived quality of care and coercive experiences measured?

Standardised instruments assessed perceived quality of care and levels of coercion, humiliation, and fear at discharge.

What were the main findings about coercion, humiliation, and fear?

Perceived quality of care was significantly associated with lower coercion and humiliation, while the association with perceived fear was less consistent. The “secluded” care-quality dimension showed the strongest association.

Sep 30, 2026

Uploaded by acoobca