Can a focused staff training programme improve the ward atmosphere and patient satisfaction in a forensic psychiatric...

The main aim of the study was to describe whether staff training and lectures on milieu therapy to nursing staff can change the treatment environment, as perceived by the patients, in a desirable direction. The study was approved by the Regional Ethics Committee for Medical Research.

To measure the patients' perceptions of the treatment environment we used the Ward Atmosphere Scale (WAS). The ward atmosphere was evaluated three times during a 12-month period. Additionally, the patients completed five questions concerning satisfaction with the treatment environment. Between the first and the second ward evaluation the nursing staff was given 3 weeks of lectures on different aspects of milieu therapy. The nursing staff completed the WAS and three satisfaction items.

The study revealed a change in desired direction after education in five of the six key subscales of the WAS (Involvement, Support, Practical orientation, Angry and aggressive behaviour and Order and organization). Staff control was the only subscale with no changes. The patients also reported an increase in satisfaction. The study revealed no major changes in the staff scores. The present study included only a small number of patients and examined the changes in only one psychiatric department; hence it could be argued that the results cannot be generalized to equivalent populations within the forensic services.

The study indicated that it is possible to improve the ward atmosphere in a desirable direction by a 3-week training programme for nursing staff about important aspects of milieu therapy.