Attitudes toward psychiatric treatment among hospitalized patients: A review of quantitative research

Abstract

Much of the data available in the literature dealing with psychiatric treatment from the point of view of hospitalized patients stem from qualitative research. Via observations, informal interviews, or masquerading as patients, social scientists have described hospital treatment and patients' attitudes toward it largely in unfavorable terms. Relatively few scientists have taken representative samples of patients, questioned them formally about treatment with objective tests or validated scales, and displayed the findings in statistical format. The present report is a review of this body of quantitative research, with special consideration given to ascertaining patients' degree of favorableness toward treatment. Results indicate that in 34 of the 44 different samples reviewed, or 77%, patients espoused favorable attitudes. Patients proved to be more favorable in their attitude toward treatment at psychiatric hospitals generally than the treatment they received at their own institution. Type of hospital and time of study had a negligible impact on patients' views. Limited data suggest that attitudes improve, or at least do not worsen, as a consequence of hospitalization. Studies that compared patient and staff attitudes reported inconsistent findings. A content analysis of the attitude measures for treatment in general revealed that patients are positive toward the hospital's therapeutic value, assistance with medical problems, restrictions, activities, and involvement of family members, negative toward its patient government and staff/patient relations, and ambivalent toward its patient freedoms and responsibilities. The content analysis of attitudes pertaining to specific therapies disclosed that indvidual, occupational, milieu, physical, recreational, and activity therapies are perceived positively by patients, group therapies negatively, and medication and ECT in an ambivalent manner. Social variables minimally affected the favorableness of patients' responses, and the impact of psychiatric variables was somewhat greater. Interpretations of these results, particularly in regard to the discrepancy between qualitative and quantitative data, are offered.