[The ecologic milieu in inpatient treatment]

Therapeutic milieus can be characterized by interactional qualities ("social atmosphere") and by ecological conditions. The paper gives a literature review on ecological aspects of the therapeutic milieu. Furthermore, a questionnaire is introduced operationalizing and measuring the quality of ecological milieus.

127 patients of two psychosomatic inpatient units were asked to evaluate the ecological milieu at home and in the hospital, using the housing milieu questionnaire.

Patients rated both the quality of their home and of the hospital-milieu rather positive. In a comparison of both milieus the patients rated the hospital better in respect to space availability, noise, building status, and conflicts with others, while the home milieu gets higher ratings for cleanliness, the availability of household devices, and the possibility to pursue own interests. The housing milieu questionnaire has a high internal consistency (home: Cronbach's alpha=0.82, clinic: Cronbach's alpha=0.83) and good retest reliability (home: r=0.895; clinic: r=0.854).

The literature review shows that the ecological milieu is an important part of the therapeutic milieu and should get more attention in science and practice. The housing milieu questionnaire allows to describe ecological aspects of the therapeutic milieu. Differences between home and hospital argue for the sensitivity of the scale. The questionnaire can be used to analyze the quality of ecological aspects of the therapeutic milieu.