Attitude variables associated with patient response to hospitalization.

Abstract

Investigations by Jones and Kahn (1Q64) have shown that patient attitudes toward mental illness and treatment are related to the social class level of the patient, which in turn is related to the type of treatment assigned. 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. Modal diagnosis was schizophrenia. Response to treatment was measured by ratings of attendance, participation, benefit from therapy, and overall progress, obtained from the principal therapist of each therapy at discharge. Ratings were correlated with attitude and demographic factors. A comparison of the initial patient attitude with that of the ward personnel was carried out.Patient attitude correlated significantly, but at low magnitudes, with length of hospitalization on three of the five attitude factors. Patients with the most authoritarian view of the hospital, and those with the most negative view of hospitalization, tended to stay the longest. However, patients 1 Reprints and an extended report of this study may be obtained without charge from

The Response of Healthcare Services to People at Risk of Suicide: a Qualitative Study

“…A high proportion of the suicidees took cannabis and/or other drugs, therefore it is possible that this behaviour may have influenced healthcare workers' responses to the suicidees, a finding supported by Rutz et al [20]. The literature suggests that aggressive, anxious or depressive behaviours displayed by at-risk patients, as well as poor compliance with prescribed treatment regimes, tend to distance clinicians from the patient, particularly where the clinician is less experienced or confidant in dealing with psychiatric symptoms [30, [32], [33], [35]].…”

“…The management of suicidal patients is complicated by the emotions expressed and demands made by the patient [28, [30], [31]], the healthcare worker's own responses to patients from different social backgrounds [32] and the influence of family and friends [28]. Positive clinical relationships between patient and clinician depends on a range of factors, such as the ability of the clinician to make a definitive diagnosis [29], the clinician's listening and attending skills, attitude and understanding of the patient's needs [33–34], the degree of patient centredness in management [33] and the expertise and experience of the clinician [29–30].…”

“…Very few studies consider community and consumer perspectives in assessing the effectiveness of existing services, important although they are [31, [35], [36], [37]]. Research indicates that degree of satisfaction with giving and receiving healthcare services is related to the time spent with patients and close others [30], patients being asked if they would consider receiving alternative treatments [30–33] and the degree of illness that is presenting [29, [30], [32]]. In other words, clinicians are more likely to give better care to people presenting with a mental illness or extreme emotional distress when the person's symptoms are easily recognised and severe, and the clinician is familiar with the required treatment schedule.…”

The Quality of Outpatient Psychiatric Care

“…Time in therapy or length of treatment was related to the level of satisfaction. It is a wellestablished finding that patients with longer time in therapy usually express a higher level of satisfaction (Roswall 1983, Kahn & Weber 1972.…”