Characteristics and related factors of individuals who refuse the support of health and welfare professionals

Abstract

OBJECTIVES: Health and welfare professionals experience difficulties during their casework on individuals in the community. The purpose of this study was to identify the characteristics and related factors of those in the community who refuse the support of health and welfare professionals. METHODS: Since 2006, based on a signed research agreement between researchers and local government office A, the series of psychiatric consultation services was initiated for healthcare professionals who experienced difficulties in carrying out their casework on individuals in the community. Data were acquired from local government office A and included the patient's basic attributes, family-related factors, psychiatric factors, and problematic behaviors. Additionally, information on whether individuals refused support was obtained. The data did not include private information. To investigate risk factors for refusing healthcare professional support, 372 profiles of patients who underwent consultation services from 2006 to 2012, were analyzed by logistic regression analysis. RESULTS: Among 309 persons, only 102 (33.0%) accepted support from health and welfare professionals, and 207 (67.0%) persons refused support. Logistic regression analysis revealed that individuals in the community who received welfare benefits (odds ratio [OR]=1.86, 95% confidence interval [CI]=1.02-3.39), refused medication (OR=2.07, 95%CI=1.10-3.90), or used abusive language towards healthcare professionals (OR=1.97, 95%CI=1.09-3.55) were more likely to refuse support from health and welfare professionals. CONCLUSION: The results indicate that individuals in the community who refused support of health and welfare professionals tend to have a worsening condition and a greater need for crisis intervention than those who did not refuse support.