Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-18T14:48:20.620Z Has data issue: false hasContentIssue false
  • English
  • Français

Perceptions of the real and the ideal ward atmosphere among trainees and staff before and after the introduction of a new work rehabilitation model

Published online by Cambridge University Press:  16 April 2020

M. Eklund  and
L. Hansson
M. Eklund*
Affiliation:
Lund University, Department of Clinical Neuroscience, Division of Occupational Therapy, PO Box 157, SE-221 00, Lund, Sweden
L. Hansson
Affiliation:
Lund University, Department of Clinical Neuroscience, Division of Psychiatry, SE-221 00, Lund, Sweden
*
*Correspondence and reprints. E-mail address:[email protected] (M. Eklund).
Get access

Summary

Changes in the ward atmosphere of a psychiatric work rehabilitation unit were investigated. Both trainees and staff filled in the Community-Oriented Programs Environment Scale (COPES) before and after a new rehabilitation model was implemented. It was hypothesised that the levels of autonomy and practical orientation would increase from both the trainees’ and staff’s perspective concerning the real ward atmosphere and that the staff’s perceptions of an ideal ward atmosphere would change in the same way. The staff perceived an increased level of autonomy with respect to both the real ward atmosphere and to what constitutes an ideal ward atmosphere, which partly confirmed the hypotheses, but the level of practical orientation was stable. Concerning the staff’s estimate of an ideal ward atmosphere, further changes were an increased level of involvement and a decrease in spontaneity, which was not hypothesised, but was not in conflict with the philosophy behind the new model. From the trainee’s perspective there was no change of either autonomy or practical orientation. Instead, there was a decrease in personal problem orientation. Compared to an optimal profile, the ward atmosphere was beneficial, before as well as after implementation of the new programme. Differences were found between the staff and the trainees, but they were not large enough to separate the groups according to what is considered an optimal profile. The few changes found support earlier conclusions that the ward atmosphere is a stable phenomenon over time.

Keywords

mental healthoccupational therapyward atmospherework rehabilitation
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 5 , August 2001 , pp. 299 - 306
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anthony, WALiberman, RP.The practice of psychiatric rehabilitation: historical, conceptual, and research base. Schizophr Bull 1986; 12: 542–59.CrossRefGoogle ScholarPubMed
Anthony, WACohen, MFarkas, M.Psychiatric rehabilitation. Boston (MA): Center for Psychiatric Rehabilitation; 1990.Google Scholar
Aubry, TBradley, LSiddique, CMLeblanc, A.Program development on an acute in-patient psychiatric unit. J Ment Health 1996; 5: 507–14.Google Scholar
BootsMiller, BJDavidson, WS IILuke, DAMowbray, CTRibisl, KMHerman, SE.Social climate differences in a large psychiatric hospital: Staff and client observations. J Community Psychol 1997; 24: 325–36.3.0.CO;2-T>CrossRefGoogle Scholar
Caplan, CA.Nursing staff and patient perceptions of the ward atmosphere in a maximum security forensic hospital. Arch Psychiatr Nurs 1993; 7: 23–9.CrossRefGoogle Scholar
Collins, JFEllsworth, RBCasey, NAHickey, RBHyer, LH.Treatment characteristics of effective psychiatric programs. Hosp Community Psychiatry 1984; 35: 601–5.Google ScholarPubMed
Ellsworth, RMaroney, RKlett, WGordon, HGunn, R.Milieu characteristics of successful psychiatric treatment programs. Am J Orthopsychiatry 1971; 41: 427–41.CrossRefGoogle ScholarPubMed
Ellsworth, R.B.Characteristics of effective treatment milieus. Gunderson, J.GWill, O.AMosher, L.R Eds.; Principles and practice of milieu therapy. New York: Jason Aronsona; 1983. 87–123.Google Scholar
Eklund, MHansson, L.Features of the ward atmosphere in a psychiatric day care unit based on occupational therapy. A comparative study. Scand J Occup Ther 1995; 2: 76–84.CrossRefGoogle Scholar
Eklund, MHansson, L.The ward atmosphere of a psychiatric day care unit based on occupational therapy: characteristics and development during a five-year period. Nord J Psychiatry 1996; 50: 117–25.CrossRefGoogle Scholar
Eklund, MHansson, L.Relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric day care unit based on occupational therapy. Acta Psychiatr Scand 1997; 95: 329–35.CrossRefGoogle Scholar
Friis, SKarterud, SKleppe, HLorentzen, SLystrup, SVaglum, P.Reconsidering some limiting factors of therapeutic communities. A summary of six Norwegian studies. Pines, MRafaelsen, L Eds.; The individual and the group. New York: Plenum Press; 1982. 573–81.CrossRefGoogle Scholar
Friis, S.Characteristics of a good ward atmosphere. Acta Psychiatr Scand 1986; 74: 469–73.CrossRefGoogle ScholarPubMed
Friis, S.Measurements of the perceived ward milieu: a reevaluation of the ward atmosphere scale. Acta Psychiatr Scand 1986; 73: 589–99.CrossRefGoogle ScholarPubMed
Goldstein, JMCohen, PLewis, SAStruening, EL.Community treatment environments. Patients vs. staff evaluations. J Nerv Ment Dis 1988; 176: 227–33.CrossRefGoogle ScholarPubMed
Hansen, JTSlevin, C.The implementation of community principles in acute care psychiatric hospital settings: an empirical analysis and recommendations to clinicians. J Clin Psychol 1996; 52: 673–8.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
James, IMilne, DLFirth, H.A systematic comparison of feedback and staff discussion in changing the ward atmosphere. J Adv Nurs 1990; 15: 329–36.CrossRefGoogle ScholarPubMed
Kellam, SGGoldberg, SCScholer, NRBerman, AShmelzer, JL.Ward atmosphere and outcome of treatment of acute schizophrenia. J Psychiatr Res 1967; 5: 145–63.CrossRefGoogle ScholarPubMed
Kielhofner, G.Conceptual foundations of occupational therapy. 2nd ed.; Philadelphia: F. A. Davis; 1997.Google Scholar
Klass, DBGrowe, GAStrizich, M.Ward treatment milieu and post-hospital functioning. Arch Gen Psychiatry 1977; 34: 1047–52.CrossRefGoogle Scholar
McKenna, HPParahoo, KABoore, JRP.The evaluation of a nursing model for long-stay psychiatric patient care: II. Presentation and discussion of findings. Int J Nurs Stud 1995; 32: 95–113.CrossRefGoogle Scholar
Melle, IFriis, SHauff, EIsland, TKLorentzen, SVaglum, P.The importance of ward atmosphere in inpatient treatment of schizophrenia on short-term units. Psychiatr Serv 1996; 47: 721–6.Google ScholarPubMed
Moffett, LAFlagg, C.Real and ideal climate perceptions of residents, staff, and visitors in a therapeutic community for substance-dependent patients. Ther Commun Int J Ther Support Org 1993; 14: 103–18.Google Scholar
Moos, RShelton, RPetty, C.Perceived ward climate and treatment outcome. J Abnorm Psychol 1973; 82: 291–8.CrossRefGoogle ScholarPubMed
Moos, RH.Evaluating treatment environments. A social ecological approach. New York: John Wiley & Sons; 1974.Google Scholar
Moos, RH.Community-oriented programs environment scale. 2nd ed.; Palo Alto (CA): Consulting Psychologists Press; 1988.Google Scholar
Moos, RH.Evaluating treatment environments. The quality of psychiatric and substance abuse programs. 2nd ed.; New Brunswick (NJ): Transaction; 1997.Google Scholar
Norusis, MJ.SPSS base 7.5 for Windows user's guide. Chicago: SPSS Inc.; 1997.Google Scholar
Smith, JGross, CRoberts, J.The evolution of a therapeutic environment for patients with long-term mental illness as measured by the Ward Atmosphere Scale. J Ment Health 1996; 5: 349–60.CrossRefGoogle Scholar
Spiegel, DYounger, JB.Ward climate and community stay of psychiatric patients. J Consult Clin Psychol 1972; 39: 62–9.CrossRefGoogle ScholarPubMed
Steiner, HMarx, LWalton, C.The ward atmosphere of a child psychosomatic unit: A ten-year follow-up. Gen Hosp Psychiatry 1991; 13: 246–52.CrossRefGoogle ScholarPubMed
Stirling, GReid, D.The application of participatory control to facilitate patient well-being: an experimental study of nursing impact on geriatric patients. Can J Behav Sci 1992; 24: 204–19.CrossRefGoogle Scholar
Vaglum, PFriis, S.Milieu therapy in the long-term treatment of functional psychoses: needed areas of research. Helgason, T Ed.; The long-term treatment of functional psychoses. Cambridge: University Press; 1985. 89–101.Google Scholar
Vaglum, PFriis, SKarterud, S.Why are the results of milieu therapy contradictory? An analysis based on four empirical studies. Yale J Biol M 1985; 58: 349–61.Google ScholarPubMed
Verinis, JS.Ward atmosphere as a factor in irregular discharge from an alcohol rehabilitation unit. Int J Addict 1983; 18: 895–9.CrossRefGoogle ScholarPubMed
Werbart, A.Exploration and support in psychotherapeutic environments for psychotic patients. Acta Psychiatr Scand 1992; 86: 12–22.CrossRefGoogle ScholarPubMed
Werbart, A.How to use therapeutic environments in the treatment of schizophrenia?. Nord J Psychiatry 1992; 46: 19–25.CrossRefGoogle Scholar
Wilmer, HW.Toward a definition of the therapeutic community. Am J Psychiatry 1958; 114: 824–33.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.