Ward atmosphere in acute psychiatric in-patient care: patients' perceptions, ideals and satisfaction

To investigate the relationship between patients' perception of the real and ideal ward atmosphere and their satisfaction.

Patients filled in the Ward Atmosphere Scale (WAS, Real and Ideal Form) and a satisfaction questionnaire. Patient characteristics were derived from clinical assessments.

WAS ratings were almost independent of patient characteristics. Patients in locked wards perceived more anger and aggression and patients subjected to coercive measures perceived less autonomy and practical orientation. Patient satisfaction was predicted by higher scores on the WAS Relationship- and System Maintenance dimensions, explaining 41% of the variance. In particular support, order and organization predicted satisfaction. Except from the areas of anger/aggression and staff control, patients gave the 'ideal' ward higher ratings on all subscales. The perceived gap between the 'ideal' and 'real' ward explained 45% of variance in satisfaction.

Patients' perception of ward atmosphere is a clinically meaningful measure appearing to be a strong predictor of satisfaction.