Einfluss einer „Offenen-Tür-Politik“ auf die Stationsatmosphäre: Auswirkungen auf die Behandlungsqualität

Zusammenfassung

Ziel der Studie war es, die Veränderung des Stationsklimas während eines Türöffnungsprozesses zu untersuchen.

Methodik Die Essen Climate Evaluation Schema (EssenCES) wurde auf neu geöffneten (n = 2, 1 Jahr), geöffneten (n = 2, 4 Jahre) und langjährig offenen (n = 2, > 20 Jahre) Stationen untersucht.

Ergebnisse Die Stationsatmosphäre auf den neu geöffneten Stationen verbesserte sich signifikant. Zwangsmaßnahmen und Entlassungen gegen ärztlichen Rat wurden reduziert.

Schlussfolgerung Die Öffnung von Akutstationen kann zu einem günstigeren Stationsklima führen.

Abstract

Objective To compare the ward atmosphere, safety, therapeutic hold, and patients’ coherence on recently opened (1 year), opened (4 years) and open (> 20 years) psychiatric wards in a longitudinal naturalistic study design. The question was if a patient shift from formerly locked to open wards might deteriorate the ward atmosphere on the open and opened wards.

Methods Ward atmosphere on two recently opened (n = 2), opened (n = 2) and open (n = 2) wards was examined using the Essen Climate Evaluation Schema (EssenCES) in a follow-up study after 4 years. Structural as well as clinical data were extracted.

Results Global ward atmosphere, safety, and patients’ coherence
on the recently opened wards was significantly increased; on always opened wards and long-term opened wards it remained unchanged. Coercive measures and discharges against medical advice decreased during the open door process.

Conclusion Opening locked psychiatric wards can help to establish a positive therapeutic atmosphere without changing the therapeutic climate on the other already open wards. A better ward atmosphere might be connected with a better therapeutic quality.

Schlüsselwörter

Akutpsychiatrie - Stationsatmosphäre - Türöffnung - Zwangsmaßnahmen - Zwangseinweisung

Keywords

acute psychiatry - open doors policy - ward atmosphere - coercive measures - involuntary treatment

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