Perceptions of the real and the ideal ward atmosphere among trainees and staff before and after the introduction of a new work rehabilitation model

Changes in the ward atmosphere of a psychiatric work rehabilitation unit we re investigated, Both trainees and staff filled in the Community-Oriented P rograms Environment Scale (COPES) before and after a new rehabilitation mod el was implemented. It was hypothesised that the levels of autonomy and pra ctical orientation would increase from both the trainees' and staff's persp ective concerning the real ward atmosphere and that the staff's perceptions of an ideal ward atmosphere would change in the same way. The staff percei ved an increased level of autonomy with respect to both the real ward atmos phere and to what constitutes an ideal ward atmosphere, which partly confir med the hypotheses, but the level of practical orientation was stable. Conc erning the staff's estimate of an ideal ward atmosphere, further changes we re an increased level of involvement and a decrease in spontaneity, which w as not hypothesised, but was not in conflict with the philosophy behind the new model. From the trainee's perspective there was no change of either au tonomy or practical orientation. Instead, there was a decrease in personal problem orientation, Compared to an optimal profile, the ward atmosphere wa s beneficial, before as well as after implementation of the new programme. Differences were found between the staff and the trainees, but they were no t large enough to separate the groups according to what is considered an op timal profile. The few changes found support earlier conclusions that the w ard atmosphere is a stable phenomenon overtime. (C) 2001 Editions scientifi ques et medicales Elsevier SAS.