==================================HSR24================================== 24. Clinical administration of psychiatric hospital or general hospital psychiatric units. Includes 'therapeutic community', 'milieu therapy', 'medical model', 'moral treatment', and 'administrative therapy'. Excludes business and financial administration and 'hospital adminini- stration'. The clinical impact upon patients of hospital/unit policies traditions, relationships of staff-members, communications, meeting schedules, etc. 1 UI - 87123669 AU - Friis S TI - Characteristics of a good ward atmosphere. AB - Thirty-five short term wards were evaluated with the WAS and a good milieu index. The results indicated that psychotic and non-psychotic patients need different types of atmosphere. Psychotic patients seem to benefit primarily from a milieu with a high level of Support, Practical orientation and Order and organization, and a low level of Anger and aggression, whereas non-psychotic patients seem to benefit mostly from a milieu with a high level of all subscales except for two: the level of Staff control ought to be low and the level of Anger and aggression ought probably to be intermediate. MH - Consumer Satisfaction ; Human ; Interpersonal Relations ; Mental Disorders/PSYCHOLOGY/*THERAPY ; *Milieu Therapy ; Professional-Patient Relations ; Psychotic Disorders/THERAPY ; Self Concept ; Support, Non-U.S. Gov't SO - Acta Psychiatr Scand 1986 Nov;74(5):469-73 2 UI - 87118598 AU - Munich RL TI - The role of the unit chief: an integrated perspective. AB - The practice of modern hospital psychiatry has led to a dramatic increase in the complexity of the role of the unit chief. Although there is a large literature on leadership functions in general, the specific and unique tasks of this role have not been delineated. In this paper, four interrelated tasks of the unit chief are described: boundary management, generation of resources, the mobilization of consensus, and consultation and evaluation. These tasks are divided into functions that address organizational and human needs and are linked with prerequisite psychological valences which enhance their implementation. Examples are designed to demonstrate functional and dysfunctional consequences of the four tasks. MH - Health Facility Administrators/*PSYCHOLOGY ; Hospital Administrators/ *PSYCHOLOGY ; Hospitals, General/MANPOWER ; Hospitals, University/ MANPOWER ; Human ; Interprofessional Relations ; Leadership ; Medical Staff, Hospital/PSYCHOLOGY ; Nursing Staff, Hospital/PSYCHOLOGY ; Psychiatric Department, Hospital/*MANPOWER/ORGANIZATION & ADMIN. ; Referral and Consultation ; Role SO - Psychiatry 1986 Nov;49(4):325-36 3 UI - 87107419 AU - Amchin J ; Polan HJ TI - A longitudinal account of staff adaptation to AIDS patients on a psychiatric unit. AB - As more patients with AIDS and AIDS-related syndromes are admitted to psychiatric units, staffs must meet new diagnostic and therapeutic challenges while adapting to the unique stresses of treating these patients. The authors discuss several case vignettes to illustrate how the staff of a voluntary acute-stay psychiatric unit progressed over a two-year period from having difficulty treating AIDS patients within the usual therapeutic milieu to directly confronting the issues raised by the disease both among themselves and in the patient community. The authors believe that the staff's ability to cope with AIDS patients may have strongly influenced the patient community's ability to cope, and that clinical experience and educational programs were major contributors to the staff's adaptation. They conclude with several recommendations for psychiatric staffs beginning to treat AIDS patients. MH - Acquired Immunodeficiency Syndrome/*PSYCHOLOGY ; Adult ; *Attitude of Health Personnel ; AIDS-Related Complex/PSYCHOLOGY ; Case Report ; Homosexuality ; Human ; Male ; Organic Mental Disorders/*PSYCHOLOGY ; Organic Mental Disorders, Psychotic/PSYCHOLOGY ; Personnel, Hospital/ *PSYCHOLOGY ; *Professional-Patient Relations ; *Psychiatric Department, Hospital SO - Hosp Community Psychiatry 1986 Dec;37(12):1235-8 4 UI - 87102434 AU - Aidroos N TI - Nurses' response to doctors' orders for close observation. AB - Informal observation seemed to show that doctors' orders for close observation were treated in a manner different from other orders for patient care. A subsequent formal study involved 26 nurses over a four-month period. Data was collected by direct observation and through brief interviews with the nurses. A shift or part-shift involving a nurse and his patient on close observation was defined as the observation unit. Only 23% of the 284 observation units complied approximately with hospital policies for close observation. Forty-one percent of the observation units were recorded as totally non-compliant. No observation unit fulfilled the policy requirements in the strictest sense. Nurses provided close observation for almost as many patients on general observation as they gave general observation to those for whom close observation had been ordered. These data suggest that in most cases nurses use something other than doctors' orders to determine the observation needs of their patients. The author suggests that doctors' orders for close and general observation be abandoned and that only orders for constant observation be retained, in conformity with what is already going on. MH - Alberta ; *Employee Performance Appraisal ; Hospitals, General/MANPOWER ; Hospitals, Teaching/MANPOWER ; Hospitals, University/MANPOWER ; Human ; Interprofessional Relations ; Nursing Staff, Hospital/*STANDARDS ; *Personnel Management ; Psychiatric Department, Hospital/*MANPOWER ; Psychiatric Nursing/*STANDARDS ; Psychiatry SO - Can J Psychiatry 1986 Dec;31(9):831-3 5 UI - 87077190 AU - Roberts JP TI - Inpatient group psychotherapy. AB - Psychiatry has available many different treatment methods. Characteristically, there is polarization between psychotherapeutic and medical approaches, seen as competing and incompatible. However, given flexibility they can be complementary and synergistic. This article reviews the place of inpatient group psychotherapy on the contemporary psychiatric ward. Its main theme is that group therapy is an important element in treatment, which to be effective should be central and not peripheral in the ward. MH - After Care ; Group Processes ; Hospitalization ; Human ; Mental Disorders/ *THERAPY ; Patient Care Team ; Professional-Patient Relations ; Psychotherapy, Group/*METHODS ; Therapeutic Community SO - Br J Hosp Med 1986 Nov;36(5):367-70 6 UI - 87006556 AU - Colson DB ; Allen JG ; Coyne L ; Dexter N ; Jehl N ; Mayer CA ; Spohn H TI - An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients. AB - Countertransference among hospital staff was investigated as part of ongoing research on difficult-to-treat psychiatric hospital patients. Staff's ratings of their emotional reactions to 127 patients on long-term units were analyzed by factor analysis, and the resulting factors were correlated by discipline with patient problem behaviors. Among the conclusions were that different forms of psychopathology elicit characteristic patterns of emotional reaction from staff; that some dimensions of psychopathology, particularly suicidal-depressed behavior and violence-agitation, elicit different emotional reactions among different disciplines, thus laying the groundwork for division among staff; and that the more difficult the process of hospital treatment, the more likely staff will experience a variety of emotions. MH - Adolescence ; Adult ; Character ; *Countertransference (Psychology) ; Emotions ; Female ; *Hospitals, Psychiatric ; Human ; Male ; Mental Disorders/PSYCHOLOGY/THERAPY ; Middle Age ; Nurse-Patient Relations ; Occupational Therapy ; Professional-Patient Relations ; Psychiatry ; Social Work ; Suicide, Attempted/PSYCHOLOGY ; Violence SO - Hosp Community Psychiatry 1986 Sep;37(9):923-8 7 UI - 87006551 AU - Drake RE ; Sederer LI TI - Inpatient psychosocial treatment of chronic schizophrenia: negative effects and current guidelines. AB - In the inpatient psychosocial treatment of schizophrenia, therapies that are intense and overstimulating often promote or prolong regression and negatively affect long-term adjustment. These approaches fail to take into account the chronicity of the disorder, the special vulnerabilities of the schizophrenic patient, and the appropriate goals of an inpatient admission. Based on a review of these problems, the authors offer several prescriptions for inpatient psychotherapy of schizophrenia: modest, well-defined goals; gentle, supportive, educational interactions with the patient; inclusion of the patient's support system and outpatient caregivers in the treatment; and attention to long-term adjustment as well as to short-term symptom removal. MH - Chronic Disease ; Family Therapy ; Goals ; Homeless Persons/PSYCHOLOGY ; *Hospitalization ; Hospitals, Psychiatric ; Human ; Interprofessional Relations ; Psychotherapy ; Regression (Psychology) ; Schizophrenia/ *THERAPY ; Social Support ; Suicide/PSYCHOLOGY SO - Hosp Community Psychiatry 1986 Sep;37(9):897-901 8 UI - 86319355 AU - Friis S TI - Factors influencing the ward atmosphere. AB - On 35 short-term wards the connection between ward atmosphere as perceived by patients and various setting and treatment characteristics was explored by the use of a hierarchical multiple regression analysis. The most important variables proved to be: mean age of patients, percentage of psychotic patients, number of patients, staff turnover rate, and interaction score. A higher mean age of patients was associated with changes in the ward atmosphere preferred by older patients. An increased percentage of psychotic patients and an increased number of patients were associated with changes which were probably anti-therapeutic for psychotic patients. Increased staff turnover was paralleled by changes which were probably unfavourable for both psychotic and nonpsychotic patients. An increased emphasis on interaction was paralleled by changes which were probably beneficial for nonpsychotic patients, but partly unfavourable for psychotic patients. MH - Adult ; Female ; *Hospital Units ; Human ; Male ; Mental Disorders/ *PSYCHOLOGY/THERAPY ; Middle Age ; *Milieu Therapy ; *Professional-Patient Relations ; *Psychiatric Department, Hospital ; *Psychiatric Status Rating Scales ; Psychotic Disorders/PSYCHOLOGY ; Support, Non-U.S. Gov't SO - Acta Psychiatr Scand 1986 May;73(5):600-6 9 UI - 86319354 AU - Friis S TI - Measurements of the perceived ward milieu: a reevaluation of the Ward Atmosphere Scale. AB - From a theoretical perspective the effect of hospital treatment depends on how the ward milieu is perceived by the patients. An objection against the measurement of patient perceptions has been that lack of reliability would invalidate the assessment. To investigate this objection 49 inpatient wards were evaluated with the Ward Atmosphere Scale (WAS). The real ward (WAS-R) scores proved to have acceptable reliability both for patients and for staff. For the ideal ward (WAS-I) scores the reliability was mostly unacceptable for both groups. The content validity of the WAS subscales was found to be acceptable by a group of experienced psychiatrists. Criterion oriented and construct validity were also acceptable, even if the WAS lacks some seemingly important variables. A comparison of WAS scores from four different countries indicated that the WAS has excellent cross-cultural properties. The WAS seems to measure fairly stable aspects of the atmosphere. The WAS scores proved to be fairly stable, even on wards where patients and staff desired considerable changes. MH - Comparative Study ; Cross-Cultural Comparison ; Great Britain ; Hospital Units/*STANDARDS ; Human ; Mental Disorders/*PSYCHOLOGY/THERAPY ; Milieu Therapy/*STANDARDS ; Norway ; *Professional-Patient Relations ; Psychiatric Department, Hospital/*STANDARDS ; *Psychiatric Status Rating Scales ; Psychometrics ; Support, Non-U.S. Gov't ; Switzerland ; United States SO - Acta Psychiatr Scand 1986 May;73(5):589-99 10 UI - 86313064 AU - Kaplan CA TI - The challenge of working with patients diagnosed as having a borderline personality disorder. AB - Patients with a borderline personality disorder evoke unique problems and treatment dilemmas among members of an inpatient treatment team. This article explores the essential interplay of various treatment modalities during the course of intensive inpatient hospitalization and also describes guidelines, approaches, and therapeutic interventions aimed at reducing destructive influences and maximizing treatment outcome. MH - Attitude of Health Personnel ; Borderline Personality Disorder/NURSING/ PSYCHOLOGY/*THERAPY ; Defense Mechanisms ; Family Therapy ; Female ; Hospitalization ; Human ; Male ; Milieu Therapy ; Nurse-Patient Relations ; Patient Care Team ; Personality Disorders/*THERAPY ; Psychotherapy, Group SO - Nurs Clin North Am 1986 Sep;21(3):429-38 11 UI - 86304974 AU - Collins J ; Hyer L TI - Treatment expectancy among psychiatric inpatients. AB - Treatment expectation (TE) is an important variable in treatment outcome. This study addressed two issues: The relationship of TE to treatment outcome and an identification of background and treatment variables most related to TE. As part of a cooperative study at 18 Veterans Administration Medical Centers on 79 general psychiatric wards, psychiatric inpatients were given the Veterans Adjustment Scale (VETS), and a significant other was mailed a Personal Adjustment and Role Skills Scale (PARS) at admission and 3 months after discharge. A Treatment Expectation measure was obtained from the VETS Scale at admission. Background and treatment factors also were obtained. Selected analyses controlled for the effects of patient input characteristics allowing for better outcome measures. Analyses also were cross validated. Results show that TE is related to treatment outcome and that a coterie of background and treatment variables are related to TE. Three factors especially influence TE-age, high vigor, and less alienation. MH - Adaptation, Psychological ; Follow-Up Studies ; Hospitals, Veterans ; Human ; Interpersonal Relations ; Male ; Mental Disorders/PSYCHOLOGY/ *THERAPY ; Middle Age ; Psychiatric Department, Hospital ; Psychological Tests ; *Set (Psychology) ; *Social Adjustment ; Support, U.S. Gov't, Non-P.H.S. SO - J Clin Psychol 1986 Jul;42(4):562-9 12 UI - 86301848 AU - Pablo RY ; Lamarre CJ TI - Parasuicides in a general hospital psychiatric unit: their demographic and clinical characteristics. AB - This study presents a profile of 89 patients admitted to the psychiatric unit of a general hospital for a deliberate but not fatal self-inflicted injury. The role of selected demographic clinical and psychosocial characteristics in the hospital admission of these parasuicide patients and their use of available services during the acute phase of their period of distress are discussed. MH - Adolescence ; Adult ; Aged ; Alberta ; Cross Sectional Studies ; Female ; Hospital Bed Capacity, 500 and over ; Hospitals, Teaching/UTILIZATION ; Human ; Interpersonal Relations ; Male ; Mental Disorders/PSYCHOLOGY ; Middle Age ; Psychiatric Department, Hospital/*UTILIZATION ; Risk ; Suicide, Attempted/OCCURRENCE/PREVENTION & CONTROL/*PSYCHOLOGY SO - Gen Hosp Psychiatry 1986 Jul;8(4):279-86 13 UI - 86299463 AU - Gray DE TI - Community and institutional roles: evaluations by Australian psychiatric nurses. AB - This paper examines Australian psychiatric nurses' evaluations of expanded nursing roles in community mental health programs and psychiatric hospitals. Factor analysis uncovered three expanded roles: two community based and one hospital based. Subsequent regression analysis found that psychiatric nurses with tertiary education and a high level of organizational commitment were more likely to favorably evaluate the expanded nursing roles. Experience related variables such as length of employment, age and rank were negatively associated with evaluations of such roles. MH - Attitude of Health Personnel ; Australia ; Community Mental Health Services/*TRENDS ; Hospitals, Psychiatric ; Human ; Mental Disorders/ *THERAPY ; Nursing Process/TRENDS ; Psychiatric Nursing/EDUCATION/*TRENDS SO - Community Ment Health J 1986 Summer;22(2):147-59 14 UI - 86276414 AU - Burti L ; Garzotto N ; Siciliani O ; Zimmermann-Tansella C ; Tansella M TI - South Verona's psychiatric service: an integrated system of community care. AB - Italy's mental health law of 1978 mandated the closing of state mental hospitals to new and former patients and the creation of comprehensive community-based service systems. The authors describe the organization, facilities and services, and treatment principles of one system created in accordance with the law--the South Verona Community Psychiatric Service, which serves a population of 75,000. Case register data for South Verona for the years 1978 to 1984 reflect the changes mandated by the law. They also indicate that despite an increase in admissions to the psychiatric ward in the general hospital following the closing of the state hospital, there was a substantial overall decrease in the number of hospital beds occupied per day by South Verona residents after passage of the law, and that a substantial proportion of patients with functional psychosis were able to be treated as outpatients. MH - Adolescence ; Adult ; Aged ; *Community Mental Health Services/ LEGISLATION & JURISPRUD./ORGANIZATION & ADMIN. ; Deinstitutionalization/ LEGISLATION & JURISPRUD. ; Family ; Hospitals, Psychiatric/LEGISLATION & JURISPRUD. ; Human ; Italy ; Mental Disorders/OCCURRENCE/THERAPY ; Middle Age ; Professional-Patient Relations ; Registries ; Social Support ; Support, Non-U.S. Gov't SO - Hosp Community Psychiatry 1986 Aug;37(8):809-13 15 UI - 86264877 AU - Jamison RN ; Lambert EW ; McCloud DJ TI - Social skills training with hospitalized adolescents: an evaluative experiment. AB - The effectiveness of social skills training on adolescent males admitted to a psychiatric hospital was evaluated through the use of empirically derived anger scenarios, blind raters, matched experimental and control treatment groups, and a repeated measures analysis. Results indicated that the social skills training effectively improved the dimension of verbal response and eye contact. Facial expression did not show measurable improvement. The use of specific skills components and scoring criteria in the social skills training was emphasized. Overall, support was found for the efficacy of social skills training for hospitalized adolescents. MH - Adjustment Disorders/PSYCHOLOGY/*THERAPY ; Adolescence ; Anger ; Antisocial Personality Disorder/PSYCHOLOGY/*THERAPY ; Assertiveness ; Behavior Therapy/*METHODS ; Child Behavior Disorders/PSYCHOLOGY/*THERAPY ; Hospitals, Psychiatric ; Human ; *Interpersonal Relations ; Male ; Verbal Behavior SO - Adolescence 1986 Spring;21(81):55-65 16 UI - 86264709 AU - Corten P ; Pelc I TI - Alcoholics and drug addicts at the emergency room of the hospital. Analysis of the staff behavior and patients' progressions. AB - The statistical analysis of a large sample (1.707 cases) was carried out using objective variables. These variables consist of the key points in the progression of alcoholics and drug addicts within two emergency departments situated in general hospitals. This study pinpoints a lack of therapeutic work at the emergency room where neither medical diagnoses nor psychopathological analyses seem to be done. MH - Alcoholism/DIAGNOSIS/*THERAPY ; Attitude of Health Personnel ; Emergencies ; Emergency Service, Hospital/*MANPOWER ; Hospitalization ; Human ; Internship and Residency ; Psychiatric Department, Hospital ; Referral and Consultation ; Social Control, Formal ; Substance Dependence/ *THERAPY SO - Acta Psychiatr Belg 1986 Mar-Apr;86(2):103-10 17 UI - 86238532 AU - Rizzardo R ; Rovea A ; Magni G TI - The general practitioner and the psychiatric health service in Italy after the reform: opinions and experiences in an urban district. AB - This paper presents an analysis of the impact of the psychiatric reform in Italy on health care delivery by the general practitioner. In an urban district of the Veneto region a survey was made on the opinions and assessments of the general practitioner about the new status of psychiatric care, on the psychiatric cases identified, and the correspondence between these opinions and assessments and the real delivery of psychiatric care. The pessimism about the psychiatric reform that emerges among some general practitioners seems to have more to do with the slow progress in creating intermediary facilities between hospital and region rather than an a priori opposition to the reform. MH - Adolescence ; Adult ; Aged ; Attitude of Health Personnel ; *Delivery of Health Care ; *Family Practice ; Hospitals, Psychiatric ; Human ; Italy ; Mental Disorders/PSYCHOLOGY/THERAPY ; *Mental Health Services ; Middle Age ; Psychiatry ; Referral and Consultation SO - Acta Psychiatr Scand 1986 Mar;73(3):234-8 18 UI - 86206513 AU - Stern DA ; Fromm MG ; Sacksteder JL TI - From coercion to collaboration: two weeks in the life of a therapeutic community. AB - The purpose of this paper is to describe an aspect of the functioning of a therapeutic community conceptualized in terms of a sociotherapy framework as adumbrated, for example, by Edelson (1970), Rapoport (1960), and White et al. (1964). This approach, as distinct from group therapy, is concerned with the social system and social conditions that form the fabric of any given behavior. In the hospital context it is the therapeutic community that provides the fabric in which interpersonal and intergroup tensions can be addressed and clarified. We will illustrate this approach by detailing a discussion between therapy and nursing staff members who consult to, and participate in, the various group meetings of the Therapeutic Community Program (TCP), which together provide the framework of this particular community. Specifically, the discussion was about the evolving nature of the engagement between the community and a borderline patient, who attempted to alter the structure and functioning of an aspect of the community program in order to meet her own needs and avoid inner conflict. The discussion will focus on the way in which the community members adhered to existing structures and functioning, and were able to utilize staff consultation to this end, despite the patient's strong pressure on them to alter it. In describing this particular case we hope to illustrate how a well-functioning therapeutic community can "hold: one of its members in a manner that allows change to take place, and also serves as an important adjunct and facilitator to individual therapy. MH - Adult ; Borderline Personality Disorder/*THERAPY ; Female ; Hospitals, Psychiatric ; Human ; Interpersonal Relations ; Personality Disorders/ *THERAPY ; Psychoanalytic Therapy ; Support, Non-U.S. Gov't ; *Therapeutic Community SO - Psychiatry 1986 Feb;49(1):18-32 19 UI - 86204874 AU - Braff J ; Way BB ; Steadman HJ TI - Incident reporting: evaluation of New York's pilot incident logging system. AB - A revised incident reporting system that combined an abbreviated logging procedure for documenting minor incidents and a more comprehensive and detailed procedure for documenting major incidents was pilot tested in three New York State adult psychiatric centers. The pilot test had two major goals: to reduce the volume of work associated with current reporting procedures, and to facilitate even more thorough investigation of incidents warranting prompt and comprehensive review. Evaluation of pilot study data showed that a logging procedure is viable for the management of minor incidents. MH - Aggression ; *Dangerous Behavior ; Financial Management/*METHODS ; *Hospital Records ; Hospitals, Psychiatric/*STANDARDS ; Hospitals, Public/ *STANDARDS ; Hospitals, State/*STANDARDS ; Human ; Medical Records, Problem Oriented ; Mental Disorders/*THERAPY ; New York ; Professional-Patient Relations ; *Records ; Risk Management/*METHODS ; *Violence ; Wounds and Injuries/ETIOLOGY SO - QRB 1986 Mar;12(3):90-8 20 UI - 86194160 AU - Nix J ; Dillon K TI - Short-term nursing therapy: a conceptual model for inpatient psychiatric care. AB - As a result of changing perspectives in psychiatric practice and increasing fiscal limits imposed by legislative and economic issues, psychiatric nurses have found their traditional models of practice challenged by shortened lengths of stay and the need for more efficient assessment and treatment. Short-term nursing therapy, which draws on the principles of crisis intervention and brief psychotherapy, was developed to provide psychiatric nurses with a cohesive, comprehensive nursing philosophy for practical application in changing inpatient settings. The authors review the development of the short-term nursing therapy concept from the perspective of the changing inpatient milieu and nurse-patient relationship. They then discuss the assumptions that constitute its framework, as well as other key factors in its implementation. MH - Goals ; Group Processes ; Human ; Length of Stay ; Mental Disorders/ *NURSING ; Models, Psychological ; *Nurse-Patient Relations ; Psychiatric Department, Hospital ; Psychiatric Nursing/*METHODS ; Transference (Psychology) SO - Hosp Community Psychiatry 1986 May;37(5):493-6 21 UI - 86184284 AU - Anscombe R TI - Treating the patient who "can't: versus treating the patient who "won't:. AB - Patients who can't do what they need to do should be treated differently than those who won't take responsibility for themselves. Mistakenly treating one as the other leads to a confusing sense of failure or may foster regression, and the clinical disagreement between colleagues readily takes on a characteristic moral tone. MH - Borderline Personality Disorder/PSYCHOLOGY/THERAPY ; Human ; Interprofessional Relations ; Milieu Therapy ; Motivation ; Patient Compliance ; *Psychotherapy ; Regression (Psychology) ; *Volition SO - Am J Psychother 1986 Jan;40(1):26-35 22 UI - 86183027 AU - Hodges V ; Sandford D ; Elzinga R TI - The role of ward structure on nursing staff behaviours: an observational study of three psychiatric wards [published erratum appears in Acta Psychiatr Scand 1986 Aug;74(2):224] AB - Variable rates of staff-patient interaction were found between three wards, which differed in the degree of programme structure, staff-patient ratios, and patient chronicity. Highest rates of staff-patient interaction occurred where a highly structured ward programme operated in a closed ward with chronically disturbed patients, and this was more likely to increase as staff-patient ratios decreased. The lowest staff-patient interaction rates occurred in acute, open and closed wards. Further, acute ward patients received negligible attention from nurses in terms of staff-patient interaction after 10 days following admission. MH - Adult ; Female ; Human ; Length of Stay ; Male ; Mental Disorders/ *THERAPY ; Middle Age ; *Nurse-Patient Relations ; Personnel Staffing and Scheduling ; *Psychiatric Department, Hospital/ORGANIZATION & ADMIN. ; Token Economy SO - Acta Psychiatr Scand 1986 Jan;73(1):6-11 23 UI - 86168933 AU - Groveman AM ; Nathan PE ; Fagley NS ; Brown EW TI - Impediments to psychiatric hospital discharge: what different professional groups think. AB - Perceived impediments to psychiatric hospital discharge were investigated across six professional groups. Seventy-nine psychologists, psychiatrists, social workers, rehabilitation personnel, registered nurses, and psychiatric aides were asked to select five behaviors and five other factors that they believed impeded hospital discharge. Violent behaviors, such as suicide, homicide, and damaging property, and financial factors, such as inadequate funds and inadequate living arrangements, emerged as the two areas that hospital staff consistently selected as principal impediments to discharge. Treatment plans of 20 patients were surveyed to ascertain whether the behaviors and other factors identified by staff were reflected in treatment goals. MH - Allied Health Personnel/PSYCHOLOGY ; *Attitude of Health Personnel ; Female ; Hospitals, Psychiatric/*STANDARDS ; Human ; Male ; Medical Staff, Hospital/PSYCHOLOGY ; Mental Disorders/*THERAPY ; Nursing Staff, Hospital/PSYCHOLOGY ; *Patient Discharge ; Personnel, Hospital/PSYCHOLOGY ; Social Work, Psychiatric ; Support, Non-U.S. Gov't SO - J Clin Psychol 1986 Mar;42(2):377-82 24 UI - 86110039 AU - Keitner GI ; Baldwin LM ; McKendall MJ TI - Copatient relationships on a short-term psychiatric unit. AB - Emotional and physical relationships among copatients on a short-term psychiatric unit were assessed in a two-year prospective study. Sixty-four relationships involving 102 patients were reported; the incidence rate was estimated at 10.7 percent. Thirty-three percent of the relationships were characterized as emotional, 9 percent as physical, and 58 percent as both. Patients involved in the relationships tended to be young and unmarried and to have a diagnosis of eating disorder, personality disorder, or bipolar disorder. Although most of the relationships were reciprocal, half were judged to be destructive and to create management problems. Staff discussed the relationship with the patients when it was considered destructive or exploitative but ignored relationships felt to be positive and healthy. The authors urge further studies of such relationships to help clarify patient management issues. MH - Adolescence ; Adult ; Age Factors ; Anger ; Appetite Disorders/PSYCHOLOGY ; Bipolar Disorder/PSYCHOLOGY ; Dependency (Psychology) ; Female ; Hospital Bed Capacity, 100 to 299 ; *Hospitals, Psychiatric ; Human ; *Interpersonal Relations ; Male ; Massachusetts ; Mental Disorders/ *PSYCHOLOGY ; Personality Disorders/PSYCHOLOGY ; Rhode Island ; Sex Behavior SO - Hosp Community Psychiatry 1986 Feb;37(2):166-70