Factors contributing to nurses' difficulty in treating patients in short-stay psychiatric settings

Difficulties experienced by nurses in treating a total of 249 patients in four short-stay psychiatric units were examined using a rating scale that assessed such factors as overall extent of treatment difficulty, patients' problem behaviors, adequacy of treatment resources, and staff members' affective responses. Data from each site were analyzed separately using stepwise hierarchical regression. The findings indicated that patient problem behaviors and treatment resources were comparable between settings. Except for patient violence, none of the problems were consistently related to overall treatment difficulty across settings. The results suggest that treatment difficulty is related to the unique combination of patient characteristics, resource deficits, and treatment philosophies in particular treatment settings and that efforts to reduce treatment difficulty should address setting-specific issues.