Associations between patient characteristics and ratings of treatment milieu

Abstract

The objective of the study was to investigate associations between patients ratings of their treatment milieu and personal characteristics such as gender, age, educational level, personality disorders, symptom distress, interpersonal problems, global level of functioning, as well as treatment outcome. Data was taken from 908 patients (with mainly personality, mood and anxiety disorders) consecutively admitted to eight day-treatment units. Treatment milieu was measured by Ward Atmosphere Scale for Therapeutic Programs (WAS-TP). Overall level of psychosocial functioning was measured by Global Assessment of Functioning (GAF). Diagnoses and personality traits was measured by the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II), according to DSM-IV. Symptom distress and interpersonal problems was measured by Symptom Checklist 90-R and the Circumplex of Interpersonal Problems, respectively. No substantial associations were found between individual personal characteristics and ratings of the treatment milieu, and no substantial associations were found between ratings of the treatment milieu and treatment outcome or the likelihood of treatment completion. There seems to be no support as to making general inferences about or from individual ratings of the treatment milieu. Possible uses of individual evaluations of treatment milieu are discussed.

Ward Climate Within a High Secure Forensic Psychiatric Hospital: Perceptions of Patients and Nursing Staff and the Role of Patient Characteristics

“…This result differs from results found in previous research where age was not found to be related to the perception of ward climate (Campbell et al, 2014;Middelboe et al, 2001;Pedersen and Karterud, 2007). In our study there was a positive relationship between age and therapeutic hold.…”

“…Pedersen and Karterud (2007) found no substantial associations between patient characteristics (gender, age, level of education, self reported symptom distress, interpersonal problems, diagnosis) and individual ratings of treatment milieu. Data were collected from patients (71% women) suffering mainly from personality, mood and anxiety disorders who had been admitted to day-treatment units.…”

“…In contrast to Dickens et al (2014) there is also research showing that patient characteristics have a small or no impact on ward climate (Moos, 1997;Pedersen & Karterud, 2007). Pedersen and Karterud (2007) found no substantial associations between patient characteristics (gender, age, level of education, self reported symptom distress, interpersonal problems, diagnosis) and individual ratings of treatment milieu.…”

“…The aim of this current study is to provide more insight into the relationship between patient characteristics and perceived ward climate. Based on previous findings, the demographic characteristics that might be related to perception of ward climate targeted in the present study were patients' age (Campbell, Allan, & Sims, 2014;Middelboe et al, 2001;Pedersen & Karterud, 2007), length of stay within the facility (van der Helm et al, 2014), and risk of violence (Dickens et al, 2014). With respect to pathological personality features, there are reports that psychopathy may be a key determinant of climate in forensic therapeutic settings (Harkins, Beech, & Thornton, 2012).…”

“…Data were collected from patients (71% women) suffering mainly from personality, mood and anxiety disorders who had been admitted to day-treatment units. Pedersen and Karterud (2007) argue that since differences between patients' views on ward climate cannot be attributed to patient characteristics they must be largely idiosyncratic. Alternative explanations for the discrepant findings with regard to the role of patient characteristics might be found in differences in methodology (using the EssenCES versus the WAS for assessing climate), and different clinical setting/samples used in the studies of Dickens and colleagues (2014) and Pedersen and Karterud (2007).…”