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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

Abstract

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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References

Guite  HF;  Clark  C;  Ackrill  G:  The impact of the physical and urban environment on mental well-being.  Public Health 120:1117–1126, 2006
[CrossRef] | [PubMed]
 
Ulrich  RS:  View through a window may influence recovery from surgery.  Science 224:420–421, 1984
[CrossRef] | [PubMed]
 
Topp  L;  Moran  J;  Andrews  J (eds):  Madness, Architecture and the Built Environment .  Abingdon,  United Kingdom,  Routledge, 2007
 
Hawthorne  WB;  Green  EE;  Folsom  D  et al:  A randomized study comparing the treatment environment in alternative and hospital-based acute psychiatric care.  Psychiatric Services 60:1239–1244, 2009
[CrossRef] | [PubMed]
 
Lloyd-Evans  B;  Slade  M;  Jagielska  D  et al:  Residential alternatives to acute psychiatric hospital admission: systematic review.  British Journal of Psychiatry 195:109–117, 2009
[CrossRef] | [PubMed]
 
Dieterich  M;  Irving  CB;  Park  B  et al:  Intensive case management for severe mental illness.  Cochrane Database of Systematic Reviews 10:CD007906, 2010
[PubMed]
 
The Pathway to Recovery: a Review of NHS Acute Inpatient Mental Health Services. London, Healthcare Commission, 2008
 
Whitehead  CC;  Polsky  RH;  Crookshank  C  et al:  Objective and subjective evaluation of psychiatric ward redesign.  American Journal of Psychiatry 141:639–644, 1984
[PubMed]
 
Christenfeld  R;  Wagner  J;  Pastva  G  et al:  How physical settings affect chronic mental patients.  Psychiatric Quarterly 60:253–264, 1989
[CrossRef] | [PubMed]
 
Devlin  A:  Physical ward renovation: staff perception and patient behaviour.  Environment and Behavior 24:66–84, 1992
[CrossRef]
 
Tyson  GA;  Lambert  G;  Beattie  L:  The impact of ward design on the behaviour, occupational satisfaction, and well-being of psychiatric nurses.  International Journal of Mental Health Nursing 11:94–102, 1992
[CrossRef]
 
Olver  J;  Love  M;  Daniel  J  et al:  The impact of a changed environment on arousal levels of patients in a secure extended rehabilitation facility.  Australasian Psychiatry :  Bulletin of Royal Australian and New Zealand College of Psychiatrists. 17:207–211, 2009
[CrossRef] | [PubMed]
 
Lawson  B;  Phiri  M:  Hospital design: room for improvement.  Health Service Journal 110:24–26, 2000
[PubMed]
 
Meehan  J;  Kapur  N;  Hunt  IM  et al:  Suicide in mental health in-patients and within 3 months of discharge: national clinical survey.  British Journal of Psychiatry 188:129–134, 2006
[CrossRef] | [PubMed]
 
Hunt  IM;  Windfuhr  K;  Swinson  N  et al:  Suicide amongst psychiatric in-patients who abscond from the ward: a national clinical survey.  BMC Psychiatry 10:14, 2010
[CrossRef] | [PubMed]
 
Dijkstra  K;  Pieterse  M;  Pruyn  A:  Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: systematic review.  Journal of Advanced Nursing 56:166–181, 2006
[CrossRef] | [PubMed]
 
Moos  RH:  Evaluating Treatment Environments: The Quality of Psychiatric and Substance Abuse Programs .  New Brunswick, NJ,  Transaction, 1997
 
Bowers  L:  Association between staff factors and levels of conflict and containment on acute psychiatric wards in England.  Psychiatric Services 60:231–239, 2009
[CrossRef] | [PubMed]
 
Røssberg  JI;  Eiring  O;  Friis  S:  Work environment and job satisfaction: a psychometric evaluation of the Working Environment Scale-10.  Social Psychiatry and Psychiatric Epidemiology 39:576–580, 2004
[CrossRef] | [PubMed]
 
Johnson  S;  Osborn  D;  Araya  R  et al:  Staff morale in the English mental health workforce: a national investigation.  British Journal of Psychiatry 201:239–246, 2012
[CrossRef] | [PubMed]
 
Wood  S;  Stride  C;  Threapleton  K  et al:  Demands, control, supportive relationships and well-being amongst British mental health workers.  Social Psychiatry and Psychiatric Epidemiology 46:1055–1068, 2011
[CrossRef] | [PubMed]
 
Weich  S;  Burton  E;  Blanchard  M  et al:  Measuring the built environment: validity of a site survey instrument for use in urban settings.  Health and Place 7:283–292, 2001
[CrossRef] | [PubMed]
 
Burton  EJ;  Mitchell  L;  Stride  CB:  Good places for ageing in place: development of objective built environment measures for investigating links with older people’s wellbeing.  BMC Public Health 11:839, 2011
[CrossRef] | [PubMed]
 
NHS National Staff Survey 2006. London, Healthcare Commission, 2006. Available at www.esds.ac.uk/doc/5736%5Cmrdoc%5Cpdf%5C5736understandingdata.pdf
 
Goldberg  DP;  Williams  P:  A User’s Guide to the General Health Questionnaire .  Windsor,  United Kingdom,  NFER-NELSON, 1988
 
Sine  DM:  The architecture of madness and the good of paternalism.  Psychiatric Services 59:1060–1062, 2008
[CrossRef] | [PubMed]
 
Fagin  L;  Carson  J;  Leary  J  et al:  Stress, coping and burnout in mental health nurses: findings from three research studies.  International Journal of Social Psychiatry 42:102–111, 1996
[CrossRef] | [PubMed]
 
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