Residents' perceptions of inpatient psychiatric care

Abstract

Psychiatric care on an inpatient unit entails the exposure of a patient to a multitude of experiences. It is generally intended that these experiences will be of benefit to the patient. A psychiatric clinician who functions in such a setting has a major responsibility for making decisions about the kinds of experiences to which any patient will be subject. He must also try to orchestrate the impact of these experiences in a way that will be of maximum benefit to the patient. This decision-making process must inevitably be influenced by the clinician's beliefs with respect to how much patients will benefit from these various experiences. These beliefs can be viewed as a set of expectations or as an ideology derived from many sources. In the course of his training, a clinician reads, learns from teachers, and deals with a variety of clinical materials and situations. Out of these emerges that analgam of experience, faith, and knowledge upon which he can draw when a decision is to be made. While reports by Myers and Rosen 1 and by Rubenstein and Laswell 2 have touched on this issue, relatively little is known about the patterns of beliefs held by psychiatric clinicians. In a previous report 3 we described residents' perceptions of the benefit derived from psychiatric hospitalization. In this study we attempt (1) to assess the beliefs of psychiatric residents regarding what aspects of hospital care benefit patients, (2) to measure these beliefs at the beginning and at the end of a period of clinical training and experience, and (3) to compare these general beliefs or stereotypes against more individualized judgments of what it is that patients actually do benefit from.