The Department of Social Work, Community and Mental Health, Canterbury Christ Church University, Canterbury, Kent CT1 1QU, United Kingdom.
Int J Nurs Stud. 2011 Nov;48(11):1349-56. doi: 10.1016/j.ijnurstu.2011.05.011.
The interests of users should lead service developments. However, it has been claimed that forensic mental health services have largely ignored examining users' views on the nature and quality of the service offered to them. Perceived social climate and perceived therapeutic relationship are viewed as important indicators of treatment outcome; however previous findings about how these variables may be associated with satisfaction with forensic services are equivocal.
This study aims to assess the levels of service user satisfaction in forensic in-patient settings in one mental health trust and explore how the perceived therapeutic relationship of the service users with their key-workers and the perceived social climate of the wards are associated with service user satisfaction.
A cross-sectional survey design was chosen and an independent researcher facilitated the completion of three standardised assessments measuring service user satisfaction, therapeutic relationships and the social climate of the ward.
Forty-four service users detained in secure settings completed the standardised assessments. The study was conducted in four medium secure and three low secure units in one NHS mental health trust. The data was analysed to examine the level of satisfaction with services and how both the therapeutic relationship and the ward environment were related to levels of satisfaction.
The majority of service users who responded were generally satisfied with services; "rehabilitation" and "perceived safety" were viewed most positively. Service users' perceptions about the social climate of the ward were found to have a significant relationship with service users' satisfaction with forensic services. However, the variables with the strongest association with satisfaction with forensic services are service users' perceptions about the nature of therapeutic relations with staff.
This study indicates that service users' satisfaction with forensic services is strongly associated with their experiences of the therapeutic relationship with their key-workers and the social climate of the ward. The findings emphasize the importance of forming and maintaining effective therapeutic relations and reinforce the need to maintain a therapeutic environment free of aggressive tension and threats of violence. The results also highlight the potential for service users to be dissatisfied with their financial situation following admission.
用户的利益应该引领服务的发展。然而，有人声称法医心理健康服务在很大程度上忽略了检查用户对向他们提供的服务的性质和质量的看法。感知的社会氛围和感知的治疗关系被视为治疗结果的重要指标；然而，关于这些变量如何与对法医服务的满意度相关的先前发现是模棱两可的。
本研究旨在评估一个心理健康信托机构法医住院环境中的服务使用者满意度水平，并探讨服务使用者与他们的主要工作人员之间的感知治疗关系以及病房的感知社会氛围如何与服务使用者满意度相关。
选择了横断面调查设计，由独立研究人员协助完成了三项评估标准，分别测量服务使用者满意度、治疗关系和病房的社会氛围。
44 名被拘留在安全环境中的服务使用者完成了标准评估。该研究在一家 NHS 心理健康信托机构的四个中级安全和三个低级安全单位进行。分析数据以检查对服务的满意度水平，以及治疗关系和病房环境如何与满意度水平相关。
大多数做出回应的服务使用者对服务总体上感到满意；“康复”和“感知安全”被认为是最积极的方面。服务使用者对病房社会氛围的看法与他们对法医服务的满意度之间存在显著关系。然而，与对法医服务的满意度关联最强的变量是服务使用者对与工作人员建立治疗关系性质的看法。
本研究表明，服务使用者对法医服务的满意度与他们与主要工作人员建立治疗关系的体验以及病房的社会氛围密切相关。研究结果强调了形成和维持有效的治疗关系的重要性，并强调需要维持一个没有攻击性紧张和暴力威胁的治疗环境。研究结果还突出了服务使用者在入院后可能对其财务状况不满意的潜在问题。
