To evaluate professionals' attitudes to recovery and coercion, as well their satisfaction with working conditions before and after the implementation of a recovery-oriented ward concept on an admission ward. Longitudinal study design with two measurement times of the study sample, with a control group assessed at study end. Evaluating the implementation of the recovery concept, attitudes towards recovery, coercion, perceptions of the ward and working satisfaction were assessed with questionnaires and computed using Chi square and ANOVA variance analyses. The members of the intervention ward (n = 17) did not differ from the control group (n = 21), except that control group members were younger. The recovery-orientation of the study ward (ROSE questionnaire) increased significantly (alpha level = 0.05) from study begin to study end (p = 0.003), and compared to the control group (p = 0.002). The attitudes towards coercion did not change significantly in the intervention group, but did so compared to the control group. The contentedness (GMI) and the satisfaction with working conditions (ABB) of the intervention group members compared to control group was significantly higher (GMI: p = 0.004, ABB subscale working conditions: p = 0.043, satisfaction: p = 0.023). The study indicates that recovery-oriented principles can be implemented even in an acute admission ward, increasing team satisfaction with work, while attitudes towards coercion did not change significantly within this single-unit project.
Background : Evaluations of the recovery orientation of mental health services have focused on outpatient and rehabilitative rather than acute inpatient facilities. Aim : This naturalistic observational study seeks to evaluate the subjective perspective and functional outcome of inpatients before and after structural alterations. The changes made were the introduction of treatment conferences and conjoint treatment planning, reduction of the total time spent on reports about patients (in their absence), and recovery-oriented staff training on an acute psychiatric unit of the University Hospital of Psychiatry, Zurich, Switzerland. Methods : During 1 year (2011/2012) eligible patients on the study unit were interviewed on a voluntary basis using established instruments to assess several recovery-relevant aspects. Two different samples (before and after the project; n 34 and n 29) were compared with regard to subjective parameters (e.g. patients ' attitudes toward recovery, quality of life, perceived coercion, treatment satisfaction, and hope), clinical and socio-demographic basic data, as well as the functional outcome according to the Health of the Nation Outcome Scales (HoNOS). Results: Some patient attitudes towards recovery and their self-assessment of the recovery process improved during the study. Other subjective parameters remained stable between samples. Functional outcome was better in subjects who were treated after the implementation of the new concept. The length of stay remained unchanged. Conclusions: The implementation of recovery-oriented structures and providing the necessary theoretical underpinning on an acute psychiatric unit is feasible and can have an impact on attitudes and knowledge of personal recovery.
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