Themes of Worry Among Psychiatric Inpatients That Persist Through Acute Hospitalization

Problems that worry patients throughout hospitalization are complex and varied, but they fall within the scope of safe, effective, patient-centered care. To our knowledge, there is no evidence describing the problems that worry patients in inpatient psychiatric units.

The purpose of this quality improvement project was to describe common themes of worry experienced by individuals in psychiatric inpatient units in order to improve patient experience.

This project took place at an urban, safety net hospital at an academic medical center in the northeastern United States between March and December 2019. All patients across five inpatient psychiatric units were offered the Combined Assessment of Psychiatric Environments (CAPE) survey as they approached the end of their stay.

A total of 1,800 patients took the survey. Of these patients, 36% (650/1,800) patients responded never/sometimes to "During my hospitalization, I found solutions to problems that worried me," and 46% (297/650) patients provided a response to the follow-up question "What are the problems that worry you the most?" Common themes of worry for inpatient behavioral health patients include (a) life in the hospital, (b) self, and (c) outside life.

Each of these worry themes that emerged from this thematic analysis has implications for behavioral health staff who are preparing the psychiatric/behavioral health inpatient for discharge. These themes can also be used to focus on a variety of quality improvement initiatives to improve the patients experience while in an inpatient psychiatric/behavioral health unit.