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.


Por: El-Abidi K, Sánchez-Balcells S, Roldan-Merino J, Ruiz AV, Cañabate-Ros M, Garcia-Sanchez JA, Muñoz-Rouco E, Pérez-Moreno JJ, Pita-De-La-Vega J, Rubia-Ruiz G, Santos-Pariente C, López AMR, Golmar LJ, López CE, Perez JG, Pastor-Bernabeu MV, Coelho J, Misouridou E, Lluch-Canut T, Puig Llobet M and Moreno-Poyato AR

Publicada: 1 feb 2026 Ahead of Print: 24 jul 2025
Resumen:
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 association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety. CONCLUSION: Higher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: For mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes. IMPACT: The study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care. REPORTING METHOD: STROBE reporting guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Filiaciones:
El-Abidi K:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

Sánchez-Balcells S:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

 Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain

Roldan-Merino J:
 Mental Health Department, Campus Docent Sant Joan de Déu, Universitat de Vic- Universitat Central de Cataumya (UVIC-UCC), Sant Boi de Llobregat, Spain

Ruiz AV:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

 Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain

Cañabate-Ros M:
 Grupo de investigación MHG, San Vicente Mártir, Universidad Católica de Valencia, Valencia, Spain

 Hospital Clínico Universitario de Valencia, Unidad de hospitalización de psiquiatría y toxicomanía, Valencia, Spain

Garcia-Sanchez JA:
 Department of Mental Health, Biomedical Research Institute of Malaga (IBIMA), University General Hospital of Málaga, Málaga, Spain

Muñoz-Rouco E:
 Psychiatry Service, Osakidetza-Basque Health Service, Galdakao-Usansolo Hospital, Galdakao-Usansolo, Spain

Pérez-Moreno JJ:
 Psychiatry Service, Osakidetza-Basque Health Service, Galdakao-Usansolo Hospital, Galdakao-Usansolo, Spain

Pita-De-La-Vega J:
 Department of Mental Health, Children's Mental Health Centre, Consorci Sanitari del Maresme, Mataró, Spain

Rubia-Ruiz G:
 Hospital Infanta Leonor, Madrid, Spain

Santos-Pariente C:
 Hospital Virgen de los Lirios, Alcoy, Alicante, Spain

López AMR:
 Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

Golmar LJ:
 Hospital Alvaro Cunqueiro, Vigo, Spain

López CE:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

Perez JG:
 Departamento de Salud de Alicante, Sant Joan d'Alacant, Spain

Pastor-Bernabeu MV:
 Departamento de Salud de Alicante, Sant Joan d'Alacant, Spain

 Departamento de Enfermería de la Facultad de Ciencias de la Salud de la, Universidad de Alicante, Alicante, Spain

Coelho J:
 Northern Health Higher School of the Portuguese Red Cross, Oliveira de Azeméis, Portugal

 RISE-Health, Nursing School of Porto (ESEP), Porto, Portugal

Misouridou E:
 Department of Nursing, University of West Attica, Egaleo, Greece

Lluch-Canut T:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

 Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain

Puig Llobet M:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

 Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain

Moreno-Poyato AR:
 Public Health, Mental Health and Maternal Infant Nursing Department, Faculty of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

 Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain
ISSN: 09621067





JOURNAL OF CLINICAL NURSING
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ, Reino Unido
Tipo de documento: Article
Volumen: 35 Número: 2
Páginas: 766-774
WOS Id: 001534720000001
ID de PubMed: 40707397
imagen Open Access

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