Ward Structure, Therapeutic Ideology, and Patterns of Patient Interaction

Acute psychiatric ward rules: a review of the literature

“…The use of quantitative methods to assess qualitative interactions seems problematic. This study elaborated on previous work that advocated persistent and clear limit setting for psychiatric patients, but also casts doubt on their recommendations (Jungman & Bucher 1967, Levinson & Crabtree 1979, Bursten et al . 1980).…”

“…Hypothetically, the rest of the patient sample might report accurately because their inpatient experiences were less coercive and restrictive. The study reflects and expands on Jungman & Bucher's (1967) findings. However, they conflict with Bursten & Geach's (1976) results, which failed to identify different patient outcomes, but this study was restricted to inpatients.…”

“…Only one of the study wards operated a formal step system, but no differences in patient outcomes were found, and the authors questioned whether the use of the formal step system was therapeutically justified. The study was limited because it used a retrospective method to evaluate therapeutic outcomes, but the results contrasted with Jungman & Bucher's (1967) findings, in which high structure improved patient compliance.…”

“…A comparative study by Jungman & Bucher (1967) evaluated the influence of ward milieu on patient behaviour. They concluded that differing ward management systems in terms of rule clarity, structure and defined staff roles accounted for variations in the frequency of rule breaking between the two wards in the study.…”

Patients’ feelings about ward nursing regimes and involvement in rule construction

“…The papers identified as appropriate to the study revealed themes associated with high structure and patient outcomes (Jungman & Bucher 1967, Levinson & Crabtree 1979, Bursten et al . 1980, Caplan 1993, Lowe et al .…”