Ward atmosphere in acute psychiatric in-patient care: patients' perceptions, ideals and satisfaction

Objective: To investigate the relationship between patients' perception of the real and ideal ward atmosphere and their satisfaction. Method: Patients filled in the Ward Atmosphere Scale (WAS, Real and Ideal F orm) and a satisfaction questionnaire. Patient characteristics were derived from clinical assessments. Results: WAS ratings were almost independent of patient characteristics. Pa tients in locked wards perceived more anger and aggression and patients sub jected to coercive measures perceived less autonomy and practical orientati on. Patient satisfaction was predicted by higher scores on the WAS Relation ship- and System Maintenance dimensions, explaining 41% of the variance. In particular support, order and organization predicted satisfaction. Except from the areas of anger/aggression and staff control, patients gave the 'id eal' ward higher ratings on all subscales. The perceived gap between the 'i deal' and 'real' ward explained 45% of variance in satisfaction. Conclusion: Patients' perception of ward atmosphere is a clinically meaning ful measure appearing to be a strong predictor of satisfaction.