RELATIONSHIPS BETWEEN CHARACTERISTICS OF THE WARD ATMOSPHERE AND TREATMENT OUTCOME IN A PSYCHIATRIC DAY-CARE UNIT BASED ON OCCUPATIONAL-THERAPY

The relationships between characteristics of the ward atmosphere and t reatment outcome in a psychiatric day-care unit were investigated. The treatment programme was based on occupational group therapy and inclu ded long-term mentally ill patients, equally distributed with regard t o psychosis and non-psychosis diagnoses. The ward atmosphere was rated on the Community-Oriented Programs Environment Scale (COPES), and out come variables concerned symptoms, global mental health, quality of li fe, and functioning in daily life. The COPES ratings were re-coded in order to control for the fact that different levels of ward atmosphere factors are recommended for psychotic and non-psychotic patients. The results revealed that an optimal initial level of anger and aggressio n in treatment was significantly associated with improvement in global mental health and functioning in everyday life. Initial optimal level s of staff control and practical orientation were significantly associ ated with improvement in psychiatric symptoms. The characteristics of the ward atmosphere at the end of the treatment period were significan tly correlated with various aspects of functioning in daily life. The study demonstrated associations with outcome variables not previously linked with ward atmosphere characteristics, e.g. functioning in daily life and quality of life.