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Articles   |    
Evaluating the Built Environment in Inpatient Psychiatric Wards
Bart Sheehan, M.D., D.M.; Elizabeth Burton, Ph.D.; Stephen Wood, Ph.D.; Chris Stride, Ph.D.; Emma Henderson, B.Sc.; Elizabeth Wearn, B.Sc.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200208
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Dr. Sheehan is affiliated with the Department of Emergency Medicine and Therapeutics, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom (e-mail: Bart.Sheehan@ouh.nhs.uk). Prof. Burton is with the Division of Mental Health and Wellbeing, University of Warwick, Coventry, United Kingdom. Prof. Wood is with the School of Management, University of Leicester, Leicester, United Kingdom. Dr. Stride is with the Institute of Work Psychology, University of Sheffield, Sheffield, United Kingdom. Ms. Henderson is with the Department of Psychology, University of Birmingham, Birmingham, United Kingdom. Ms. Wearn is with the Department of Psychology, University of Surrey, Guilford, United Kingdom.

Copyright © 2013 by the American Psychiatric Association


Objective  Research on inpatient psychiatric care has paid little attention to the built environment of psychiatric wards. This study described the built environment in a sample of inpatient psychiatric wards in England and investigated relationships between staff satisfaction with the built environment of the ward and objective design features of the environment.

Methods  Trained researchers completed a checklist of built-environment characteristics of 98 inpatient wards in England in 2007–2009. Interrater reliability was assessed and confirmed. Staff on these wards completed a three-item measure assessing the ward for overall design, fitness for purpose, and role in ensuring safety. Multilevel modeling was used to test relationships between built-environment features and staff satisfaction.

Results  A total of 1,540 staff responded. The wards encompassed a wide variety of service types and built-environment features. Staff satisfaction with the built environment was associated with noncorridor design and with the provision of personal bathrooms for patients. No association with observability of patients, exterior views, or other facilities was found. There was no difference between nurses and other groups in satisfaction with overall design, but nurses rated ward environment lower on ensuring safety (p=.036) and on fitness for purpose (p=.012).

Conclusions  Objective measurement of the built environment in inpatient psychiatric settings is feasible and can be used to identify features that increase user satisfaction.

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Table 1Characteristics of 98 inpatient psychiatric wards
Table Footer Note

a Characteristics of staff were obtained by a survey of 1,540 clinical staff; some respondents did not provide complete information.

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Table 2Ratings of the physical environment of 98 inpatient psychiatric wards by 1,540 staffa
Table Footer Note

a The number of respondents for each item was 1,508 for overall design, 1,460 for fitness for purpose, and 1,483 for safety.

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Table 3Characteristics of the built environment of 98 inpatient psychiatric wards
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Table 4Predictors of satisfaction with the built environment among 1,540 staff of 98 inpatient psychiatric wards


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