An evaluation of the effect of programme changes in an acute psychiatric unit.

This article describes a research project in which nurses evaluated the effect of changes in a unit programme in a situation where staffing and other resources are severely limited. A quasi-experimental design was used in which the situation before the change was compared with the situation after implementation of the new programme. The dependent variables were patient symptoms and interaction patterns in the unit. The study was done in an acute female psychiatric inpatient unit in a large state psychiatric hospital in South Africa with predominantly black Zulu speaking patients. It was found that the changed programme did not increase the total interactions in the unit significantly, but that it did increase neutral interactions and decreased negative interactions. It also kept the rate of interaction steady over time between patients and staff and steadily increased interaction between patients themselves. In the control group all interactions decreased over time. No significant difference was found in symptoms between the two groups. It is concluded that the structured programme in a unit may change interaction patterns positively, even when poor staffing makes it possible only to plan nursing care for groups of patients rather than individuals. Whether these changes in interaction will be transferred to family and friends in the longer term, still has to be explored.