The ethological study of four psychiatric wards: behavior changes associated with new staff and new patients

Healing Architecture for Sick Kids

Abstract. Scientific data are sparse on hospital design in child and adolescent psychiatry. The present article aims to give an overview of various concepts of hospital design and to develop concepts how architecture can consider the special needs of children and adolescents in their recovery from psychiatric diseases. Literature research is provided from PubMed and collected from architectural and anthroposophic bibliography. Access to daylight and nature, reduced level of noise and an atmosphere of privacy are general principles to support convalescence in patients. Especially in psychiatry, spatial structures and colour can strengthen appropriate social interrelations on both the patient and staff level. Authors suggest that children and adolescents benefit from architectural concepts which consider the issues: Welcome, Path, Territory, Area of Freedom, Outdoor Space, Access to Light, Motion in the Structure and Orientation of Space.

The quality of psychiatric nurses' interactions with patients: an observational study

The behaviour of nursing staff in each ward of a psychiatric hospital was observed at 5-min intervals for between 7 and 10 h per day for 10 days. The nurses' behaviour was equally divided between interacting with patients, interacting with staff, solitary task oriented behaviour and other behaviours. There was less staff-patient interaction in the acute ward than in the long-term and psychogeriatric wards and senior nurses interacted less with patients and engaged in more solitary task oriented behaviour. Of the interactions with patients, almost 25% were rated as positive and only 0.3% negative. In the long-term wards almost 47% of the interactions were positive.

A quantitative study of nursing staff interactions in psychiatric wards

Data from 2 studies investigating staff-patient and staff-staff interaction rates are presented. In the first the staff-patient ratio was varied by holding patient numbers constant and systematically varying staffing levels. The results showed that although the percentage of time nurses spent interacting with patients did not change, staff-staff interaction increased as a function of increased staffing levels. In the second study the interaction rates from 4 wards were combined. These data showed that, as in the first study, staff-patient interaction remained constant, as staff numbers increased, whilst staff-staff interaction increased. However, unlike the first study, when analysed in terms of the staff-patient ratio, both categories of interaction increased as the staff-patient ratio increased.

The role of ward structure on nursing staff behaviours: an observational study of three psychiatric wards

Variable rates of staff-patient interaction were found between three wards, which differed in the degree of programme structure, staff-patient ratios, and patient chronicity. Highest rates of staff-patient interaction occurred where a highly structured ward programme operated in a closed ward with chronically disturbed patients, and this was more likely to increase as staff-patient ratios decreased. The lowest staff-patient interaction rates occurred in acute, open and closed wards. Further, acute ward patients received negligible attention from nurses in terms of staff-patient interaction after 10 days following admission.

Hospital treatment of elderly neuropsychiatric patients. I. Initial clinical and administrative experience with a new teaching ward

Program planning and the initial experience of a new teaching ward for geriatric psychiatry are described. Elderly psychiatric patients, with diagnoses predominantly of depression and dementia, demonstrate more self-centeredness and less group awareness than do younger patients. Ward staff members often experience frustration, sadness and anger in response to working with them. Major problems unique to a geriatric psychiatry service include the paucity of adequate resources for post-discharge care and the necessity to obtain excellent medical-surgical consultation and support.