ABSTRACT

The purpose of this study was to explore clinical staff and resident perceptions regarding the importance, as well as effectiveness, of environmental qualities and features in mental and behavioural health (MBH) facilities. The study evaluated inadequacies in environmental attributes, as perceived by staff and residents, in four MBH facilities in the United States. The Psychiatric Staff Environmental Design tool and the Psychiatric Patient Environmental Design tool were used to capture perceptions and facility assessments. We examined the importance of various environmental attributes, the differences between the importance and how effectively these attributes were achieved, and the differences between psychiatric staff and resident responses. The most important qualities for residents were a well-maintained environment and suicide resistance. For staff, the most important qualities were staff safety and security and suicide resistance. Rated across all facilities, staff reported significant differences between importance and effectiveness of environmental attributes (p < .0001) whereas residents did not report differences. Significant differences were found between staff and patient ratings of existing facilities (p = .004), with staff reporting more inadequacies than residents. Findings suggest a strong need for more supportive physical MBH environments, particularly from the perspective of staff. Though residents reported fewer inadequacies, more evidence-based design guidelines for MBH environments are needed.

摘要

本研究的目的是探讨临床工作人员和居民对心理和行为健康 (MBH) 设施中环境质量和特征的重要性和有效性的看法。该研究评估了美国四个 MBH 设施的工作人员和居民认为的环境属性不足。精神病学工作人员环境设计工具和精神病学患者环境设计工具用于捕获感知和设施评估。我们检查了各种环境属性的重要性、重要性之间的差异以及这些属性如何有效地实现，以及精神科工作人员和居民反应之间的差异。对居民来说，最重要的品质是维护良好的环境和抗自杀能力。对于员工来说，最重要的品质是员工的安全保障和抗自杀能力。在所有设施的评级中，工作人员报告环境属性的重要性和有效性之间存在显着差异（p < .0001）而居民没有报告差异。现有设施的工作人员和患者评级之间存在显着差异（p = .004），工作人员报告的不足之处比居民多。调查结果表明强烈需要更多支持性的物理 MBH 环境，特别是从员工的角度来看。尽管居民报告的不足之处较少，但仍需要更多基于证据的 MBH 环境设计指南。