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Impact of the hospital built environment on treatment satisfaction of psychiatric in-patients

Published online by Cambridge University Press:  22 October 2020

Nikolina Jovanović*
Affiliation:
Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Queen Mary University of London, UK
Elisabetta Miglietta
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
Anja Podlesek
Affiliation:
Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
Adam Malekzadeh
Affiliation:
Centre for Transport Studies (CTS), Department of Civil, Environmental & Geomatic Engineering, University College London, London, UK
Antonio Lasalvia
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy UOC Psichiatria, Azienda Ospedaliera Universitaria Intergrata di Verona, Verona, Italy
Justin Campbell
Affiliation:
Institute of Global Health, University College London, UK
Stefan Priebe
Affiliation:
Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Queen Mary University of London, UK
*
Author for correspondence: Nikolina Jovanovic, E-mail: n.jovanovic@qmul.ac.uk

Abstract

Background

A hospital built environment can affect patients’ treatment satisfaction, which is, in turn, associated with crucial clinical outcomes. However, little research has explored which elements are specifically important for psychiatric in-patients. This study aims to identify which elements of the hospital environment are associated with higher patient satisfaction with psychiatric in-patient care.

Methods

The study was conducted in Italy and the United Kingdom. Data was collected through hospital visits and patient interviews. All hospitals were assessed for general characteristics, aspects specific to psychiatry (patient safety, mixed/single-sex wards, smoking on/off wards), and quality of hospital environment. Patients’ treatment satisfaction was assessed using the Client Assessment of Treatment Scale (CAT). Multi-level modelling was used to explore the role of environment in predicting the CAT scores adjusted for age, gender, education, diagnosis, and formal status.

Results

The study included 18 psychiatric hospitals (7 in Italy and 11 in the United Kingdom) and 2130 patients. Healthcare systems in these countries share key characteristics (e.g. National Health Service, care organised on a geographical basis) and differ in policy regulation and governance. Two elements were associated with higher patient treatment satisfaction: being hospitalised on a mixed-sex ward (p = 0.003) and the availability of rooms to meet family off wards (p = 0.020).

Conclusions

As hospitals are among the most expensive facilities to build, their design should be guided by research evidence. Two design features can potentially improve patient satisfaction: family rooms off wards and mixed-sex wards. This evidence should be considered when designing or renovating psychiatric facilities.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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