1
|
Rodwell D, Frith H. 'A ward full of emotional, aggressive people': Social climate and interpersonal relationships in forensic settings caring for patients with borderline personality disorder. Int J Ment Health Nurs 2024; 33:1049-1061. [PMID: 38400517 DOI: 10.1111/inm.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Therapeutic relationships play a central role in maintaining a positive social climate in forensic settings. The interpersonal difficulties characteristic of Borderline Personality Disorder, alongside the secure environment of forensic wards, can make developing positive therapeutic relationships with this patient group challenging. Qualitative interviews aimed to explore how ward staff understand and experience the interaction of interpersonal relationships and social climate when caring for patients with Borderline Personality Disorder on forensic wards. Interviews with 11 staff members working across UK forensic inpatient settings were analysed using Reflexive Thematic Analysis and reported following COREQ guidelines. Six interrelated themes were generated; three describe relational cycles that occur between ward staff and patients with Borderline Personality Disorder and three describe systemic factors that influence the context in which ward staff operate. From these themes, an integrative model was developed to summarise how factors in the wider forensic system and the interpersonal relationships between staff and patients with Borderline Personality Disorder in forensic wards influence one another, affecting staff experiences of the social climate of forensic settings. The model illustrates how complex cycles within the therapeutic relationships with staff and patients with Borderline Personality Disorder can interact with systemic influences in the wider forensic context to influence staff experiences of forensic settings. Clinical implications of the model are discussed, offering recommendations for improving therapeutic relationships and the social climate on forensic wards caring for patients with Borderline Personality Disorder, to better support staff and patient wellbeing.
Collapse
Affiliation(s)
- Devon Rodwell
- School of Psychology, University of Surrey, Guildford, UK
| | - Hannah Frith
- School of Psychology, University of Surrey, Guildford, UK
| |
Collapse
|
2
|
E M A E, J J R, G H P VDH, E J E H, C H Z K, K S N, S V, J D L, G J J M S, E K, A T H, M A. Safety First! Residential Group Climate and Antisocial Behavior: A Multilevel Meta-analysis. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024:306624X241252052. [PMID: 38855815 DOI: 10.1177/0306624x241252052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
A systematic review and multilevel meta-analysis was performed (28 studies and 313 effect sizes) on the relation between residential group climate (i.e., safety, atmosphere, repression, support, growth, structure) and antisocial behavior, including aggression and criminal recidivism. A systematic search was conducted in PsychINFO, ERIC, and OVID Medline up to February 2023. Results showed a small but significant association (r = .20) between residential group climate and antisocial behavior, equivalent to a 23% reduction of antisocial behavior in all clients receiving care in a residential facility with a therapeutic group climate. Moderator analyses showed that experienced safety was more strongly related to antisocial behavior (r = .30) than the other dimensions of group climate (.17 < r < .20), while the effect size was somewhat larger for adults (r = .24) than for youth (r = .15). We conclude that residential facilities should consider safety as a priority and should involve clients in a positive process of change through the development of a therapeutic environment and delivery of evidence-based treatment, addressing their needs from the perspective of rehabilitation.
Collapse
Affiliation(s)
- Eltink E M A
- University of Amsterdam; GGZ Centraal, the Netherlands
| | - Roest J J
- University of Applied Sciences Leiden, the Netherlands
| | - Van der Helm G H P
- University of Amsterdam; University of Applied Sciences Leiden, the Netherlands
| | | | - Kuiper C H Z
- University of Amsterdam; University of Applied Sciences Leiden, the Netherlands
| | - Nijhof K S
- Academic Workplace for at-risk Youth (AWRJ); Pluryn; Radboud University Nijmegen, the Netherlands
| | | | | | | | - Knorth E
- University of Groningen, the Netherlands
| | - Harder A T
- Erasmus University Rotterdam, the Netherlands
| | - Assink M
- University of Amsterdam, the Netherlands
| |
Collapse
|
3
|
Corbetta M, Corso B, Camuccio CA. Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions. Int J Ment Health Nurs 2022; 31:611-624. [PMID: 35128772 PMCID: PMC9305954 DOI: 10.1111/inm.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self-concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward's environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit's rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients' needs.
Collapse
Affiliation(s)
| | - Barbara Corso
- Neuroscience InstituteNational Research CouncilPadovaItaly
| | | |
Collapse
|
4
|
Conflict management: A qualitative study of mental health staff's perceptions of factors that may influence conflicts with forensic mental health inpatients. Arch Psychiatr Nurs 2021; 35:407-417. [PMID: 34561053 DOI: 10.1016/j.apnu.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/09/2021] [Accepted: 06/12/2021] [Indexed: 11/23/2022]
Abstract
Internationally, clinical services are under pressure to reduce their use of restrictive practices. The aim was to explore how mental health nurses and nursing assistants perceive conflict and their use of restrictive practices with mental health inpatients in forensic mental health care. A total of 24 semi-structured interviews with forensic mental health staff were conducted and analysed using thematic analysis. The findings propose a dynamic model that explains how tolerance of potential conflict situations changes depending on individual staff members' perceptions of patients and colleagues, and their relationships.
Collapse
|
5
|
Büsselmann M, Titze L, Lutz M, Dudeck M, Streb J. Measuring the Quality of Life in Forensic Psychiatric Hospitals. Front Psychol 2021; 12:701231. [PMID: 34305762 PMCID: PMC8299050 DOI: 10.3389/fpsyg.2021.701231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
Background: In Germany, a large proportion of mentally ill offenders spends many years in a forensic psychiatric hospital. To ensure that the highly restrictive living conditions in these closed institutions meet patient needs, research must assess and analyze patient quality of life. For this purpose, we adapted the Measuring the Quality of Prison Life questionnaire to measure the quality of life in forensic psychiatric hospitals from the patient perspective. This study aimed to assess the reliability (internal consistency) and construct validity of the adapted questionnaire. Methods: To evaluate the questionnaire, a one-time survey was carried out at 13 forensic psychiatric hospitals in Germany. Item characteristics and internal consistency of the scale and subscales were calculated and the factor structure was tested using confirmatory factor analysis. To test of responsiveness we compared the mean quality of life between the 13 hospitals and further investigated whether the patients' evaluation of quality of life is depending on age and duration of accommodation. Results: The analysis of the psychometric properties revealed very good item characteristics and very good to excellent internal reliability. Construct validity was demonstrated. Patient's quality of life was significantly associated with age and duration of accommodation. Discussion: The adapted Measuring the Quality of Prison Life questionnaire is a reliable and valid instrument for measuring quality of life in forensic psychiatric hospitals and can be used in the future to compare hospitals and identify the strengths and weaknesses of each.
Collapse
Affiliation(s)
- Michael Büsselmann
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Larissa Titze
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Maximilian Lutz
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Judith Streb
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| |
Collapse
|
6
|
Hallett N, Dickens GL. The violence prevention climate of mental health wards: a cross-sectional study of staff and patient views. Soc Psychiatry Psychiatr Epidemiol 2021; 56:97-107. [PMID: 32232505 DOI: 10.1007/s00127-020-01860-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 03/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Ward climate can shape the behaviour of both staff and patients. A subset of the ward climate is the violence prevention climate, the unique characteristics that are perceived by the people within the environment as contributing towards the prevention of violence. The aim of this study was to explore differences between and within staff and patient groups in terms of their perceptions of the violence prevention climate. METHODS A cross-sectional survey was conducted with staff (n = 326) and patients (n = 95) in mental health care pathways within one charitable trust. All participants completed the VPC-14 to measure perceptions of the violence prevention climate, a validated 14-item two-factor scale (staff actions and patient actions). Staff demographic information was collected on the VPC-14 front sheet; patient demographic, clinical and violence data were collected from electronic case records. Bivariate analyses were conducted to compare within- and between-group variables. Significant staff and patient variables were entered into multiple hierarchical regression analyses to assess their relationship with VPC-14 factors. RESULTS Staff had a more positive view than patients of staff actions and patients had a more positive view of patient actions than did staff; staff- or patient-group membership was the best predictor of staff action scores. Individual staff characteristics accounted for a small amount of the variance in staff and patient action scores; individual patient characteristics explained more variance, but this was still below 20%. CONCLUSIONS Staff perceive their violence prevention-related contributions more positively than patients and vice versa. This has implications for staff; they may need to better articulate their role in violence prevention to patients, as well as recognise the role that patients play. However, within staff and patient groups, individual variables only make up a small amount of variance of perceptions of the violence prevention climate. This suggests that the violence prevention climate is a valid construct, i.e. that despite differences in individual variables, individuals within the patient group have similar perceptions of the VPC, as do those within the staff group.
Collapse
Affiliation(s)
- Nutmeg Hallett
- St Andrew's Healthcare, Cliftonville Road, Northampton, NN1 5DG, UK. .,University of Northampton, Park Campus, Boughton Green Road, Northampton, NN2 7AL, UK. .,School of Nursing, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Geoffrey L Dickens
- Centre for Applied Nursing Research, Western Sydney University and South West Sydney Local Health District, 1 Campbell Street, Liverpool, NSW, 2170, Australia
| |
Collapse
|
7
|
Oates J, Topping A, Ezhova I, Wadey E, Marie Rafferty A. An integrative review of nursing staff experiences in high secure forensic mental health settings: Implications for recruitment and retention strategies. J Adv Nurs 2020; 76:2897-2908. [PMID: 32951214 DOI: 10.1111/jan.14521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 07/23/2020] [Indexed: 12/12/2022]
Abstract
AIMS To identify the experiences of nursing in high secure forensic mental health settings that may affect staff recruitment and retention. BACKGROUND Recruitment and retention of Registered Nurses is a vital international concern in the field of mental health. The high secure forensic setting presents unique challenges for the nurse. Studies of nurse's experiences in this setting have not previously been reviewed in the context of workforce sustainability pressures. DESIGN An integrative review (Whittemore and Knapfl, 2005). DATA SOURCES A systematic search of data sources: MEDLINE (PubMed), PsycINFO, EMBASE, CINAHL, International Bibliography of the Social Sciences, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, ProQuest Social Sciences Premium collection (IBSS, PAIS, and Sociological Abstracts), and Web of Science from inception to December 2019. REVIEW METHODS Data extraction, quality appraisal, and convergent qualitative synthesis. RESULTS Fifteen papers were selected for inclusion in the review, describing 13 studies. Six studies were quantitative, all cross-sectional surveys. There were seven qualitative studies, using a variety of methodologies. Four themes were identified: engagement with the patient group, the ward social environment, impact on the nurse, and implications for practice. CONCLUSION When policymakers address workforce shortages in high secure forensic nursing they must take account of the unique features of the setting and patient group. Nurses must be adequately prepared and supported to function in an ethically and emotionally challenging environment. IMPACT This study identified factors affecting workforce pressures in the speciality of forensic mental health nursing. Findings are of interest to national nursing policymakers and workforce leads in mental health service provider organizations, seeking to promote forensic nursing as a career option and retain nursing staff.
Collapse
Affiliation(s)
- Jennifer Oates
- Florence Nightingale Faculty of Nursing, King's College London, London, UK
| | - Alice Topping
- Florence Nightingale Faculty of Nursing, King's College London, London, UK.,West London NHS Trust, London, UK
| | - Ivanka Ezhova
- Florence Nightingale Faculty of Nursing, King's College London, London, UK
| | - Emma Wadey
- NHS England and NHS Improvement, London, UK
| | | |
Collapse
|
8
|
Hottinen A, Rytilä-Manninen M, Laurén J, Autio S, Laiho T, Lindberg N. Impact of the implementation of the safewards model on the social climate on adolescent psychiatric wards. Int J Ment Health Nurs 2020; 29:399-405. [PMID: 31808286 DOI: 10.1111/inm.12674] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2019] [Indexed: 01/10/2023]
Abstract
The Safewards model was created to reduce conflict and containment in psychiatric inpatient units. The model suggests alternative methods for containment and aims to create a safer hospital experience for both patients and staff. The evaluation of this model has provided evidence that it might be implemented on adolescent psychiatric wards. This study evaluated the impact of the implementation process of the Safewards model on the social climate of adolescent psychiatric inpatient wards by using the Essen Climate Evaluation Schema questionnaire. The study was carried out on six closed wards of one Finnish hospital district. Data were collected at baseline (42 adolescent inpatients and 134 staff members) and after the implementation of the model (39 inpatients and 115 staff members). The data were analysed using the Mann-Whitney U-test. The findings of this preliminary study indicate that inpatients' experience of patient cohesion and therapeutic hold and staff members' experience of safety on adolescent psychiatric wards might be improved by the implementation of the Safewards model on adolescent psychiatric wards.
Collapse
Affiliation(s)
- Anja Hottinen
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Minna Rytilä-Manninen
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Jenny Laurén
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Silva Autio
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Tero Laiho
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Nina Lindberg
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, HUS, Helsinki, Finland
| |
Collapse
|
9
|
Laker C, Cella M, Callard F, Wykes T. The impact of ward climate on staff perceptions of barriers to research-driven service changes on mental health wards: A cross-sectional study. J Psychiatr Ment Health Nurs 2020; 27:281-295. [PMID: 31755618 DOI: 10.1111/jpm.12577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 11/12/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: To date, improvements on U.K. acute mental health wards have been difficult to sustain. The barriers to change may be context dependent. Mental health wards are volatile workplaces with service user violence/aggression, frequent staff and patient changes, and ongoing service improvements. The evidence suggests that burnout affects staff perceptions of barriers to change, and ward climate affects burnout. As two potentially important, independent predictors of staff perceptions of barriers to change, the impact of ward climate and burnout on how staff regard changes should be considered. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Elements of ward climate such as high numbers of incidents and temporary staff independently worsened mental health staff perceptions of barriers to change, in addition to negative impacts from burnout and occupational status. How staff perceived ward climate was also linked their perceptions of barriers to change; however, burnout was no longer a significant consideration with these variables. Staff with low job satisfaction and high interaction anxiety also had low confidence regarding changes. Staff with low job satisfaction were also demotivated towards changes. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Ward climate is clearly an important factor in how nurses view organizational changes. In this study, nurses' perceptions of barriers to change were worse if they viewed ward climate negatively, or if temporary staff and incident numbers were high. Staff perceptions of ward climate and barriers to change should be assessed, ahead of service changes. Developing change strategies based on such information is likely to produce better implementation outcomes. Specifically, targeting staff confidence and motivation (which are barriers to change) may improve how staff regard their ward climate. Abstract Introduction To create successful change programmes for mental health wards, it is necessary to understand which aspects of ward climate prevent change. Question Does ward climate influence mental health nurse's perceptions of barriers to change? Method Random-effects models were used to test whether the following ward climate variables influenced the outcome measure "staff perceptions of barriers to change" (VOCALISE) and its subscales (powerlessness/confidence/demotivation): (a) Perceptions of ward climate (VOTE: subscales included work intensity/job satisfaction/interaction anxiety). (b) Ward climate indicators (incidents/detention under the Mental Health Act (2007)/staffing/bed pressure). As known predictors of VOCALISE, burnout (Maslach Burnout Inventory) and occupational status were included in the models. Results Perceptions of ward climate (VOTE), incidents, temporary staff, occupational status and burnout significantly and negatively affected perceptions of barriers to change (VOCALISE). Staff with low job satisfaction (VOTE) and high interaction anxiety (VOTE) also had low confidence (VOCALISE). Staff with low job satisfaction (VOTE) were also demotivated (VOCALISE). Discussion Ward climate is an important predictor of how staff regard service changes in mental health wards. Implications for practice Staff perceptions of ward climate and barriers to change should be assessed ahead of service changes to identify pressures that impede progress and lower morale.
Collapse
Affiliation(s)
- Caroline Laker
- Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Matteo Cella
- Department of Psychology, Psychology & Neuroscience, King's College, Institute of Psychiatry, London, UK
| | - Felicity Callard
- Birkbeck's Department of Psychosocial Studies, University of London, London, UK
| | - Til Wykes
- Department of Psychology, Psychology & Neuroscience, King's College, Institute of Psychiatry, London, UK.,South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| |
Collapse
|
10
|
Behandlungsevaluation im Jugendmaßregelvollzug. FORENSISCHE PSYCHIATRIE PSYCHOLOGIE KRIMINOLOGIE 2019. [DOI: 10.1007/s11757-019-00551-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Ireland CA, Ireland JL, Jones NS, Chu S, Lewis M. Predicting security incidents in high secure male psychiatric care. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 64:40-52. [PMID: 31122639 DOI: 10.1016/j.ijlp.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/20/2018] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE The contribution of environmental and organisational factors in predicting security incidents within a high secure male psychiatric setting is considered using a series of connected studies; a systematic literature review comprising 41 studies and five inquiries (Study 1) to identify core themes of likely importance; application of these themes to incident data through assessment of the ward culture, as perceived by 73 male psychiatric patients and 157 staff (Study 2); and detailed examination of noted relevant factors in the form of interpersonal style, meaningful activity and physical environmental characteristics in a study comprising 62 patients and 151 staff (Study 3). It was predicted that security incidents would be identified through inclusion of environmental and organisational factors. RESULTS The systematic review demonstrated the importance of accounting for staff characteristics, patient interactions, physical environment and meaningful activity. The subsequent study noted the importance of only specific aspects of the social environment, with the final study demonstrating that incidents were associated with controlling interpersonal styles of staff, lower perceived fairness, and less involvement in off-ward activities. Perception of fair treatment and off-ward activities mediated the staff interpersonal style and security incident relationship. CONCLUSIONS The research proposes a preliminary framework - the McKenna Framework for understanding Incidents in Secure Settings (M-FISS) - to explain the occurrence of security incidents in secure psychiatric care.
Collapse
Affiliation(s)
- Carol A Ireland
- School of Psychology, University of Central Lancashire, Darwin Building, Preston PR1 2HE, UK; Ashworth Research Centre, Mersey Care NHS Trust, OER Building, Parkbourn, Maghull L31 1HW, UK.
| | - Jane L Ireland
- School of Psychology, University of Central Lancashire, Darwin Building, Preston PR1 2HE, UK; Ashworth Research Centre, Mersey Care NHS Trust, OER Building, Parkbourn, Maghull L31 1HW, UK
| | - Naomi S Jones
- School of Psychology, University of Central Lancashire, Darwin Building, Preston PR1 2HE, UK; Ashworth Research Centre, Mersey Care NHS Trust, OER Building, Parkbourn, Maghull L31 1HW, UK
| | - Simon Chu
- School of Psychology, University of Central Lancashire, Darwin Building, Preston PR1 2HE, UK; Ashworth Research Centre, Mersey Care NHS Trust, OER Building, Parkbourn, Maghull L31 1HW, UK
| | - Michael Lewis
- School of Psychology, University of Central Lancashire, Darwin Building, Preston PR1 2HE, UK; Ashworth Research Centre, Mersey Care NHS Trust, OER Building, Parkbourn, Maghull L31 1HW, UK
| |
Collapse
|
12
|
Siess J, Schalast N. Psychometric Properties of the Essen Climate Evaluation Schema (EssenCES) in a Sample of General Psychiatric Wards. Arch Psychiatr Nurs 2017; 31:582-587. [PMID: 29179825 DOI: 10.1016/j.apnu.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 06/11/2017] [Accepted: 08/01/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The questionnaire EssenCES (Essen Climate Evaluation Schema) is a widely used instrument to assess social climate in forensic psychiatric and correctional institutions. The purpose of this study was to evaluate the EssenCES in a general psychiatric setting, where it had not previously been evaluated. DESIGN 648 staff members and 551 patients from 47 general psychiatric wards across 16 hospitals in Germany completed the EssenCES. Factor-, correlation- and scale-analyses were carried out to inspect the questionnaire's properties. RESULTS The proposed three-dimensional factor structure of the instrument was confirmed. Results indicated that the EssenCES subscales Patients' Cohesion and Experienced Safety had high internal consistency, whereas elimination of item 16 would improve the internal consistency of Therapeutic Hold. Correlations between the EssenCES subscales and other measures supported the validity of the questionnaire. CONCLUSION The results suggest that the EssenCES is suitable for usage in general psychiatric settings. Along with its brevity, it seems useful as an economic and valid screening instrument for a ward's social climate. Reasons are given why item 16 should be retained.
Collapse
Affiliation(s)
- Julia Siess
- Institut für Forensische Psychiatrie, Universität Duisburg-Essen, LVR-Klinikum Essen, Postfach 103043, 45030 Essen, Germany.
| | - Norbert Schalast
- Institut für Forensische Psychiatrie, Universität Duisburg-Essen, LVR-Klinikum Essen, Postfach 103043, 45030 Essen, Germany.
| |
Collapse
|