The concept of the therapeutic milieu was developed when patients' hospitalizations were long, medications were few, and one-to-one nurse-patient interactions were the norm. However, it is not clear how the notion of 'therapeutic milieu' is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, 'What stands out to you about this psychiatric hospital environment?' Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged-in by the Plexiglas-enclosed nursing station, and patients felt caged-in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse-patient relationship was yearned for by nurses, it was nearly absent from patients' descriptions. The caring experienced by patients was mainly derived from interactions with other patients.
Spatial human experiences such as confinement and freedom are important to acute psychiatric care. The physical space that inpatient psychiatric/mental health nurses and acute psychiatric patients share influences human relationships. The purpose of this paper is to explore the meanings of space and place in acute psychiatric settings, to discuss how these meanings affect human relationships, nurses' work environment and patients' perception of care, and to present how the design and use of nursing stations affects therapeutic relationships. We hope to encourage dialogue and research that will help clarify the meaning of space and place in acute care psychiatric units, and make for healthier work environments for nurses and healing care environments for patients.
Gefühlsstörungen begegnen Therapeuten im beruflichen Alltag häufig. Ihre Klienten berichten oft von komischen und pelzigen Empfindungen. Diese genauer zu beschreiben fällt ihnen schwer. Die ZweiPunkt-Diskrimination ist eine Möglichkeit, um die Oberflächensensibilität objektiv zu messen und zu dokumentieren.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.