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Should severely disturbed psychiatric patients be distributed or concentrated in specialized wards? An empirical study on the effects of hospital organization on ward atmosphere, aggressive behavior, and sexual molestation

Published online by Cambridge University Press:  16 April 2020

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Summary

This study examines whether ward atmosphere, aggressive behavior, and sexual molestation will change after severely disturbed patients have been distributed over several wards determined by their place of residence, instead of concentrating them in locked single-sex wards. Four wards for predominantly psychotic patients were investigated with the German version of the Ward Atmosphere Scale (WAS), and some further questions about the observation of aggressive behavior and sexual molestation once before and twice after internal sectorisation, partial ward opening, and mixing the sexes were asked. Questionnaires (345: 162 staff members, 183 patients) were evaluated. After the structural changes, a significant improvement of ward atmosphere and a reduction of aggressive behavior was found on average in all wards, whereas the impact on sexual molestation remained unclear. Internal sectorisation and sex integration policy, resulting in distributing rather than concentrating severely disturbed patients, have beneficial effects on the social climate of acute wards.

Type
Original article
Copyright
Copyright © 1999 Éditions scientifiques et médicales Elsevier SAS.

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References

Akhtar, SCrocker, EDickey, NHelfrich, JWilliam, RNRheuban, J. Overt sexual behavior among psychiatric inpatients. Dis Nerv Sys 1977; 38: 359361.Google ScholarPubMed
Canfield, MMuller, JClarkin, JWhitmarsh, JThorward, SREmbretson, S. Issues in research design in psychiatric hospitals. Psychiatr Hosp 1988; 19: 1126.Google ScholarPubMed
Clark, DH. The therapeutic community. Br J Psychiatry 1977; 131: 553564.CrossRefGoogle ScholarPubMed
Crabtree, LHGrossman, WK. Administrative clarity and redefinition for an open adolescent unit. Psychiatry 1974; 37: 350359.CrossRefGoogle ScholarPubMed
Eichhorn, H. Braucht die Psychiatrie geschlossene Stationen? Psychiatr Neurol Med Psychol 1986; 38: 3942.Google Scholar
Ellsworth, RBCharacteristics of effective treatment milieus.In: Gunderson, JGWill, OAMosher, LR eds. Principles and practice of milieu therapy. New York: Jason Aronson; 1983. p. 7685.Google Scholar
Engel, RKnab, BDolbhoff-Thun, VC. Stationsbeurteilungsbogen SBB: manual. Weinheim: Beltz; 1983.Google Scholar
Enquête über die Lage der Psychiatrie in der Bundesrepublik Deutschland. Schluβbericht der Sachverständigen-Kommission. Bonn: Bundestagsdrucksache 7-4200; 1975. p. 215223.Google Scholar
Gebhardt, RPSteinert, T. Innere Struktur der stationären psychiatrischen Krankenhausversorgung 22 Jahre nach der Psychiatrie-Enquête. Nervenarzt 1998; 69: 791798.CrossRefGoogle Scholar
Gebhardt, RPSteinert, T. Schwierige Patienten konzentrieren oder verteilen? Auswirkungen von innerer Sektorisierung, partieller Stationsöffnung und Geschlechtermischung auf das Behandlungsmilieu. Psychiat Prax 1999; 26: 6166.Google Scholar
Gebhardt, RPSteinert, T. Einstellungen von Patienten und Personal zu gemischtgeschlechtlichen Stationen in der Akutpsychiatrie. Krankenhauspsychiatrie 1999. in press.Google Scholar
Gruyters, TPriebe, S. Die Bewertung psychiatrischer Behandlung durch die Patienten — Eine Studie zu ihrer Erfassungsmethodik und zeitlichen Stabilität. Fortschr Neurol Psychiatr 1992; 60: 140145.CrossRefGoogle Scholar
Gunderson, JGAn overview of modern milieu therapy.In: Gunderson, JGWill, OAMosher, LR eds. Principles and practice of milieu therapy. New York: Jason Aronson; 1983. p. 113.Google Scholar
Hingley, SMGoodwin, AM. Living with the opposite sex: the views of long-stay psychiatric patients. Br J Clin Psychol 1994; 33: 183192.CrossRefGoogle ScholarPubMed
Letemendia, FJJHarris, ADWillems, PJA. The clinical effects on a population of chronic schizophrenic patients of administrative changes in hospital. Br J Psychiatry 1967; 113: 959971.CrossRefGoogle ScholarPubMed
Lewis, ABKohl, RN. The risk and prevention of abscondance from an open psychiatric unit. Compr Psychiatry 1962; 3: 302308.CrossRefGoogle ScholarPubMed
Lion, JRMadden, DJChristopher, RL. A violence clinic: three years’ experience. Am J Psychiatry 1976; 133: 432435.Google ScholarPubMed
Moos, RWard atmosphere scale: manual. Palo Alt: Consulting Psychologists Press 1974.Google Scholar
O'Driscoll, MPEvans, R. Organizational factors and perceptions of climate in three psychiatric units. Hum Relations 1988; 41: 371388.CrossRefGoogle Scholar
Schwartz, RAMako, AESmith, Q. Patient management in an 100% open hospital. Hosp Com Psychiatry 1972; 23: 8587.Google Scholar
Skoda, C. Statistische Untersuchungen zum Problem des Open-Door-Systems. Schweizer Arch Neurol Neurochir Psychiatr 1968; 102: 223234.Google Scholar
Spengler, CKeller, TKruckenberg, P. Erfahrungen und Materialien zur inneren Sektorisierung psychiatrischer Groβkrankenhäuser. Psychiat Prax 1987; 14: 6069.Google Scholar
Trudel, GDesjardins, G. L'attitude du personnel face à la sexualité des personnes séjournant en institution psychiatrique. Sci Comportement 1990; 20: 194210.Google Scholar
Wing, JBrown, G. Institutionalism and schizophrenia: a comparative study of three mental hospitals 1960-1968. Cambridge: Cambridge University Press; 1970.CrossRefGoogle Scholar
Young, CL. A therapeutic community with an open door in a psychiatric receiving service. Arch Neurol Psychiatry 1959; 81: 335340.CrossRefGoogle Scholar
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