Title of article :
Shift climate profiles and correlates in acute psychiatric
inpatient units
Author/Authors :
Terry J. Lewin، نويسنده , , Vaughan J. Carr، نويسنده , , Agatha M. Conrad، نويسنده , , Ketrina A. Sly، نويسنده , , Martin Cohen
Srinivasan Tirupati، نويسنده , , Martin Cohen، نويسنده , , Philip B. Ward، نويسنده , , Tim Coombs، نويسنده ,
Issue Information :
ماهنامه با شماره پیاپی سال 2012
Abstract :
Purpose Inpatient psychiatric units are dynamic in nature,
potentially creating a different treatment experience
for each person, which may be difficult to quantify. Among
the goals of this multi-centre service evaluation project was
an assessment of shift-to-shift changes in unit-level events
and their impact on the social–emotional environment.
Methods Over 1 year, various nurse-completed logs were
used within the 11 participating Australian psychiatric
units (n = 5,546 admissions) to record patient- and unitlevel
events per shift, including ratings of the overall
social–emotional climate using a novel shift climate ratings
(SCR) scale (n = 8,176 shifts). These were combined with
admission-level patient characteristics to investigate shift
climate profiles and correlates.
Results Occupancy rates averaged 88% and two-thirds of
admissions were involuntary. The psychometric performance
of the SCR scale was considered to be satisfactory (e.g., high
internal consistency, unidimensional factor structure, and
evidence of discriminant and predictive validity). A series of
hierarchical regressions revealed considerable variation in
SCR total scores, with poorer climates being significantly
associated with: day/afternoon shifts; higher occupancy
levels; higher proportions of experienced staff, and male,
older, or involuntary patients; higher rates of less serious
aggressive incidents; reporting of additional staffing demands;
and unit location in a stand-alone psychiatric hospital.
Conclusions The day-to-day social–emotional climate
can have important consequences for patient engagement
and recovery. Improved understanding of the role played by
unit, staff and patient characteristics, together with routine
monitoring, should facilitate the development and evaluation
of targeted interventions to reduce adverse incidents
and improve the overall social–emotional climate.
Keywords :
Inpatients Mental disorders Psychiatrichospitals Psychometrics Service evaluation Social environment
Journal title :
Social Psychiatry and Psychiatric Epidemiology (SPPE)
Journal title :
Social Psychiatry and Psychiatric Epidemiology (SPPE)