Should severely disturbed psychiatric patients be distributed or concentrated in specialized wards? An empirical study on the effects of hospital organization on ward atmosphere, aggressive behavior, and sexual molestation

This study examines whether ward atmosphere, aggressive behavior, and sexua l molestation will change after severely disturbed patients have been distr ibuted over several wards determined by their place of residence, instead o f concentrating them in locked single-sex wards. Four wards for predominant ly psychotic patients were investigated with the German version of the Ward Atmosphere Scale (WAS), and some further questions about the observation o f aggressive behavior and sexual molestation once before and twice after in ternal sectorisation, partial ward opening, and mixing the sexes were asked . Questionnaires (345: 162 staff members, 183 patients) were evaluated. Aft er the structural changes, a significant improvement of ward atmosphere and a reduction of aggressive behavior was found on average in all wards, wher eas the impact on sexual molestation remained unclear. Internal sectorisati on and sex integration policy, resulting in distributing rather than concen trating severely disturbed patients, have beneficial effects on the social climate of acute wards. (C) 1999 Editions scientifiques et medicales Elsevi er SAS.