Relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric day-care unit based on occupational therapy.

Abstract

The relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric day-care unit were investigated. The treatment programme was based on occupational group therapy and included long-term mentally ill patients, equally distributed with regard to psychosis and non-psychosis diagnoses. The ward atmosphere was rated on the Community-Oriented Programs Environment Scale (COPES), and outcome variables concerned symptoms, global mental health, quality of life, and functioning in daily life. The COPES ratings were re-coded in order to control for the fact that different levels of ward atmosphere factors are recommended for psychotic and non-psychotic patients. The results revealed that an optimal initial level of anger and aggression in treatment was significantly associated with improvement in global mental health and functioning in everyday life. Initial optimal levels of staff control and practical orientation were significantly associated with improvement in psychiatric symptoms. The characteristics of the ward atmosphere at the end of the treatment period were significantly correlated with various aspects of functioning in daily life. The study demonstrated associations with outcome variables not previously linked with ward atmosphere characteristics, e.g. functioning in daily life and quality of life.