Dataset Information

Exploring the initial experience of hospitalisation to an acute psychiatric ward.

ABSTRACT: BACKGROUND:Patient-reported satisfaction with inpatient psychiatric services, within the first few days of admission, is related to positive future outcomes. Despite its predictive value, little is known about this initial experience and what underlies these appraisals. The aim of this study was to qualitatively explore the initial experience of being admitted to an inpatient psychiatric ward. METHODS:Semi-structured interviews were conducted with 61 recently admitted patients across five psychiatric hospitals in London, England. Participants were purposively sampled to ensure a mix of experiences including people with high and low satisfaction scores as measured by the Client Assessment of Treatment. Thematic analysis was used to identify, analyse and report patterns within the data, with content analysis applied to determine whether certain themes were more common to either negative or positive appraisals. RESULTS:Four broad themes were evident 1) 'Best place for me right now?' 2) 'Different from out in society' 3) 'Moving from uncertainty to being informed' and 4) 'Relating & Alienating'. Individuals with very positive appraisals spoke most frequently of helpful relationships with both staff and other patients, and feeling cared for. They also spoke of having had previous admissions and the assessment process on entering the ward suggesting that these may be valuable experiences. Conversely, the group with very negative appraisals spoke of relationships that were alienating or where there was a perceived abuse of power. They described restrictions to their freedom, compared hospital to prison and generally had the view that hospital makes you worse. CONCLUSIONS:The experience of hospital within the first few days of admission determines whether an individual has a positive or negative experience of their inpatient care. Reducing the impact of uncertainty and promoting good relationships may help services to improve the initial experience of hospital admission and ultimately improve future outcomes for patients.

SUBMITTER: Chevalier A

PROVIDER: S-EPMC6122813 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Exploring the initial experience of hospitalisation to an acute psychiatric ward.

Chevalier Agnes A Ntala Eleni E Fung Catherine C Priebe Stefan S Bird Victoria J VJ

PloS one 20180904 9

<h4>Background</h4>Patient-reported satisfaction with inpatient psychiatric services, within the first few days of admission, is related to positive future outcomes. Despite its predictive value, little is known about this initial experience and what underlies these appraisals. The aim of this study was to qualitatively explore the initial experience of being admitted to an inpatient psychiatric ward.<h4>Methods</h4>Semi-structured interviews were conducted with 61 recently admitted patients acr ...[more]

PMID: 30180196

Similar Datasets

Project description:BackgroundAlteration in thyroid activity is a well-known cause of symptoms mimicking psychiatric disorders. There are reports on altered levels of thyroid hormones in patients with certain psychiatric disorders compared to healthy controls; still, the magnitude and importance of the phenomenon is not known. We wanted to explore the level of thyroid hormones in different diagnostic groups in an acute-psychiatric population. We also wanted to follow any change during their stay.MethodsPatients aged 18 years and older admitted to a closed, psychiatric inpatient ward were eligible if giving informed consent. For 539 patients representing all main psychiatric diagnostic groups and with equal gender distribution, data for FT4 were available for 539 patients, and data for TSH were available from 538 patients at admittance. For 239 patients, data for FT4 were available at both admittance and discharge, and the corresponding number for TSH was 236 patients.ResultsA significantly higher share of patients had higher levels of FT4 and TSH at admittance than expected for healthy individuals. No significant effect of gender or most diagnostic groups was seen. For female patients with substance-use disorder (SUD), the level of TSH was significantly lower than that for all other diagnostic groups. No other difference in the levels of FT4 and TSH was seen between the main diagnostic groups, and the effect in SUD was not seen in males. For the population with available markers at both admittance and discharge, in total, there was a significant reduction of FT4 from admittance to discharge, not followed by any change in TSH.ConclusionsIn acutely admitted psychiatric patients there seems to be an increased FT4 and TSH. FT4 is normalized during the inpatient stay independently of TSH. This indicates somatic effects of psychiatric stress that may be of clinical importance and the phenomenon should be further explored. Mainly different diagnostic groups did not differ in level of FT4 and TSH. Thus future studies on thyroid activity in psychiatric patients should focus on function and level of stress and suffering rather than diagnostic groups.

Project description:BackgroundIn recent years, neuroimaging has been used increasingly to explore the biological underpinnings of violence carried out by schizophrenia patients (SPs). Studies have focused mostly on patients with a history of carrying out severe physical assaults, or comorbid with substance abuse/personality disorder (SA/PD). As a result, participants were unrepresentative and the interpretation of brain-structure changes was confusing. Here, we concentrated on SPs on a general psychiatric ward with a history of relatively lower violence, and individuals comorbid with SA or PD were excluded. We expected to identify the characteristics of brain morphometry in this population, and to explore whether the morphometric changes were universal.MethodsForty-eight violent schizophrenia patients (VSPs), twenty-seven non-VSPs (nVSPs) and 28 nonviolent healthy controls (HCs) were investigated. Voxel-based morphometry was used to evaluate the gray matter volume (GMV) of all study participants. Whole-brain analyses were used to reveal group effects and differences between any two groups. Correlation analyses were undertaken between significant brain regions and behavioral measurements in the VSP group.ResultsPatients showed a significantly smaller GMV in widespread frontal, temporal, and limbic regions compared with HCs. No region was found in which the two patient groups had significantly larger volumes compared with that in HCs. A significant decrease in the GMV of the right fusiform gyrus was found in the VSP group compared with that in the nVSP group (p = 0.004), where the GMV of this region had a negative correlation with the Physical Aggression [subscale of the Modified Overt Aggression Scale (MOAS)] or Hostility score. The VSP group showed a trend of GMV decrease in the left middle temporal cortex compared with that in the nVSP group (p = 0.077). Negative correlation was also found between the GMV of left inferior temporal gyrus/left Superior frontal gyrus, medial and the Hostility score.ConclusionsOur results provide initial evidence demonstrating the generalizability of GMV abnormalities in SPs engaged in varying levels of violence, even when SA or PD have not been implicated. GMV reduction was correlated with only the Physical Aggression subscale score of the MOAS, suggesting that this change in brain morphology may be dependent upon different types of violent actions.

Dataset Information

Exploring the initial experience of hospitalisation to an acute psychiatric ward.

Publications

Exploring the initial experience of hospitalisation to an acute psychiatric ward.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure