Ward atmosphere in acute psychiatric inpatient care: differences and similarities between patient and staff perceptions.

The purpose of the study was to compare patient and staff perceptions of the social climate in a psychiatric department, in order to investigate to what extent the two groups agree in their view of the ward milieu. Ninety-six patients and 66 staff members answered the Ward Atmosphere Scale (WAS) questionnaire, comprising a 100-item "real-form" concerning the ward atmosphere as it is actually perceived and a 100-item "ideal-form" concerning the atmosphere in an imagined "best of all" ward. Staff scores were significantly higher than patient scores on the WAS-R subscales Involvement, Spontaneity, Practical orientation, Personal problems orientation and Program clarity, and on the WAS-I subscales Spontaneity, Practical orientation, and Anger and aggression. Patient scores were significantly higher than staff scores on the WAS-R subscale Staff control and on the WAS-I subscales Support, Autonomy and Staff control. At the same time, the findings showed that the WAS-profiles of the two groups were highly concordant regarding both "realities" and "ideals". In conclusion, patients and staff do to some extent differ in their perception of the social climate in the ward. However, the differences seem to reflect nuances in views rather than fundamental differences in opinion. From an overall point of view, the findings suggest a basic agreement between patients and staff regarding the valuation of the treatment environment as well as the general preferences concerning the ward milieu.