Skip to main content Accessibility help
×
×
Home

Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences

  • David P. J. Osborn (a1), Brynmor Lloyd-Evans (a1), Sonia Johnson (a1), Helen Gilburt (a2), Sarah Byford (a2), Morven Leese (a2) and Mike Slade (a2)...

Abstract

Background

Alternatives to traditional in-patient services may be associated with a better experience of admission.

Aims

To compare patient satisfaction, ward atmosphere and perceived coercion in the two types of service, using validated measures.

Method

The experience of 314 patients in four residential alternatives and four standard services were compared using the Client Satisfaction Questionnaire (CSQ), the Service Satisfaction Scale – Residential form (SSS–Res), the Ward Atmosphere Scale (WAS) and the Admission Experience Scale (AES).

Results

Compared with standard wards, service users from alternative services reported greater levels of satisfaction (mean difference CSQ 3.3, 95% CI 1.8 to 4.9; SSS–Res 11.4, 95% CI 5.0 to 17.7). On the AES, service users in alternatives perceived less coercion (mean difference –1.3, 95% CI –1.8 to –0.8) and having more ‘voice’ (mean difference 0.9, 95% CI 0.6 to 1.2). Greater autonomy, more support and less anger and aggression were revealed by WAS scores. Differences in CSQ and AES scores remained significant after multivariable adjustment, but SSS–Res results were attenuated, mainly by detention status.

Conclusions

Community alternatives were associated with greater service user satisfaction and less negative experiences. Some but not all of these differences were explained by differences in the two populations, particularly in involuntary admission.

Copyright

Corresponding author

Dr David Osborn, Department of Mental Health Sciences, University College London, Rowland Hill Street, London NW3 2PF, UK. Email: d.osborn@medsch.ucl.ac.uk.

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
1 Rose, D. Users' Voices: The Perspectives of Mental Health Service Users on Community and Hospital Care. Sainsbury Centre for Mental Health, 2001.
2 Quirk, A, Lelliott, P. What do we know about life on acute psychiatric wards in the UK? A review of the research evidence. Soc Sci Med 2001; 53: 1565–4.
3 Killaspy, H, Dalton, J, McNicholas, S, Johnson, S. Drayton Park, an alternative to hospital admission for women in acute mental health crisis. Psychiatr Bull 2000; 24: 101–4.
4 Johnson, S, Bingham, C, Billings, J, Pilling, S, Morant, N, Bebbington, P, et al. Women's experiences of admission to a crisis house and to acute hospital wards: a qualitative study. J Ment Health 2004; 13: 247–62.
5 Johnson, S, Gilburt, H, Lloyd-Evans, B, Boardman, J, Leese, M, Osborn, D, et al. In-patient and residential alternatives to standard acute psychiatric wards in England. Br J Psychiatry 2009; 194: 456–63.
6 Barker, P. The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing. J Psychiatr Ment Health Nurs 2001; 8: 233–40.
7 Johnson, S, Lloyd-Evans, B, Morant, N, Gilburt, H, Shepherd, G, Slade, M, et al. Alternatives to acute in-patient care in England: roles and populations served. Br J Psychiatry 2010 (suppl 53): s613.
8 Attkisson, C, Zwick, R. The Client Satisfaction Questionnaire: psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann 1982; 5: 233–7.
9 Greenfield, TK, Attkisson, CC. Steps toward a multifactorial satisfaction scale for primary care mental health services. Eval Prog Plann 1989; 12: 271–8.
10 Gardner, W, Hoge, S, Bennett, N, Roth, L, Lidz, C, Monahan, J, et al. Two scales for measuring patients' performance perceptions of coercion during hospital admission. Behav Sci Law 1993; 20: 307–21.
11 Moos, KH. Evaluation of Treatment Environments. Wiley, 1974.
12 Lloyd-Evans, B, Johnson, S, Morant, N, Gilburt, H, Osborn, DPJ, Jagielska, D, et al. Alternatives to standard acute in-patient care in England: differences in content of care and staff–patient contact. Br J Psychiatry 2010 (suppl 53): s4651.
13 Slade, M, Byford, S, Barrett, B, Lloyd-Evans, B, Gilburt, H, Osborn, DPJ, et al. Alternatives to standard acute in-patient care in England: short-term clinical outcomes and cost-effectiveness. Br J Psychiatry 2010 (suppl 53): s149.
14 Gilburt, H, Slade, M, Rose, D, Lloyd-Evans, B, Johnson, S, Osborn, DPJ. Service users' experiences of residential alternatives to standard acute wards: qualitative study of similarities and differences. Br J Psychiatry 2010 (suppl 53): s2631.
15 Svensson, B, Hansson, L. Patient satisfaction with inpatient psychiatric care. The influence of personality traits, diagnosis and perceived coercion. Acta Psychiatr Scand 1994; 90: 379–84.
16 Iversen, KI, H⊘yer, G, Sexton, H. Coercion and patient satisfaction on psychiatric acute wards. Int J Law Psychiatry 2007; 30: 504–11.
17 Byford, S, Sharac, J, Lloyd-Evans, B, Gilburt, H, Osborn, DPJ, Leese, M, et al. Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge. Br J Psychiatry 2010 (suppl 53): s205.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences

  • David P. J. Osborn (a1), Brynmor Lloyd-Evans (a1), Sonia Johnson (a1), Helen Gilburt (a2), Sarah Byford (a2), Morven Leese (a2) and Mike Slade (a2)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *