A factorial study of patient attitudes toward mental illness and psychiatric hospitalization

Abstract

235the newly admitted patient is more prone to elope. While the assault rate is lower than expected, and seems not to support the relationship between patients' age and length of hospitalization and assaults, it must be remembered that dist,urbed patients from this building are usually transferred to building 7.The major implication of these results is that temporal and demographic variables should be considered when assigning patients to a given building treatment program. Such assignments could allow increased supervision of patients who are more likely to be involved in the critical incidents. While from a therapeutic viewpoint, building transfer may be undesirable, such assignments might reduce the likelihood of the patient doing harm to himself or others.Service cunriection. Table 1 shojvs that only the incidence of elopements was significantly related to this variable. Patients who had service connected disabilities tended to elope more frequently than those whose disabilities were not service connected. A possible explanation of this result is that the veteran with a non-service connected disability might fear that he will not be readmitted upon his return, whereas the service connected patient does not have this fear.SUMMARXThis study iiivest,igated the temporal aiid demographic correlates of assault, injury, and elopement, as examples of what might be considered as "critical incidents" in a neuropsychiatric hospital. The data on a number of temporal and deniographic variables were found to be related to the occurrence of assaults, iiijury, and elopements. In general, it is the younger, more acutely disturbed, and more recently hospitalized patient who is involved in the critical incident. A t the other extreme, it is the older, more chronic, aiid cont,inually hospitalized patient who is infrequently involved in the critical incident.These results ivere discussed in terms of the standard dichottomy of psychiatric diagnosis, chronic versus acute disturbance. Although it is the younger, more acutely disturbed patient who has the best prognosis for recovery, and is therefore given the most intensive treatment program, it is this same patient who is most often involved in a critical incident. It was suggested that the hospital programmed for intensive rehabilitation may need a larger and more thoroughly trained staff, not only for the treatment program itself, but to aid in the prevention of critical incidents. PROBLEMconsistently demonstrating that social class and ethnic-cultural factors covary with incidence and treatment of psychiatric illness. The present investigators share the view of Hollingshead and Redlich that the attitudes and values of patients are an integral part of the demonstrated correlations. We mould go further and suggest that attitudes are the clinically useful mediating factors in the correlations between social class variables and phenomena of treatment.

Psychopathology, Treatment Outcome and Attitude Toward Mental Illness in Mexican American and European Patients

“…Mexican American patients scored significantly higher than European American patients on factor I (authoritarian control and non-psychological orientation, P = .035), indicating a stronger view of the hospital as &dquo;an external source of control and restriction over behaviour in which the control is manifest through non-psychological means. Feelings and emotions are suppressed, while matters of custodial care are important.&dquo; (Kahn et al, 1963). Such an attitude toward mental illness and hospitalisation may be a factor in the under-utilisation by Mexican American patients, since the hospital is viewed by them as a very controlling, restricting place.…”

“…The attitude measure, similarly administered before and after, was the CPH Factor Scale (Kahn et al, 1963), which consists of 45 statements concerning mental disorder, hospitalisation and treatment. It is scored on five factor analytically derived dimensions: I. Authoritarian control and non-psychological orientation; II.…”

Failure of a moral enterprise: Attitude of the public toward mental illness.

“…After asking Korean patients to indi-cate their position on such statements as "The best place to get hold of yourself is a psychiatric hospital" and "This hospital is like a prison for keeping people locked up," the investigators factor analyzed the total scale. Kahn, Jones, MacDonald, Conners, and Binchard (1963) had already carried out this procedure on American patients. Having available the major factors which had been extracted from both the American and Korean patients' responses, Kahn and his coworkers proceeded to contrast the two groups on their views toward mental illness and "patienthood."…”

Attitude variables associated with patient response to hospitalization.

“…Response to treatment as a function of attitude toward hospitalization has had little previous investigation. The present study aimed at determining the relationship of such patient attitudes to aspects of hospital course, such as response to treatment and length of stay, to patient demographic factors, and to attitudes of ward personnel.Consecutive admissions to a psychiatric ward were administered the CPH Factor Attitude Scale (Kahn, Jones, Macdonald, Conners, & Burchard, 1963) upon admission and prior to discharge. The SI male veterans had a mean age of 38.9 years, mean education of 12.2 years, and mean hospital stay of 26.94 days.…”

“…Consecutive admissions to a psychiatric ward were administered the CPH Factor Attitude Scale (Kahn, Jones, Macdonald, Conners, & Burchard, 1963) upon admission and prior to discharge. The SI male veterans had a mean age of 38.9 years, mean education of 12.2 years, and mean hospital stay of 26.94 days.…”