Collins J F, Ellsworth R B, Casey N A, Hyer L, Hickey R H, Schoonover R A, Twemlow S W, Nesselroade J R
J Clin Psychol. 1985 May;41(3):299-308. doi: 10.1002/1097-4679(198505)41:3<299::aid-jclp2270410302>3.0.co;2-a.
This large Veterans Administration cooperative study sought to identify the ward milieu characteristics of effective psychiatric programs. It was developed as a multivariable, correlational study that involved systematic observations of program characteristics and outcome effectiveness of wards as they operated in their usual manner. Seventy-nine wards in 18 hospitals provided 11,283 patients eligible for follow-up. Eleven treatment characteristics were found to be correlated to patients' community adjustment 3 months after discharge. These characteristics were classified into five general categories: Patient-staff interaction, patient activities, medication practices, ward physical environment, and nursing staff rotation. The major conclusions are: wards do differ in their effectiveness as measured by ratings of patient posthospital adjustment; and treatment characteristics make a difference in program effectiveness as measured by patients' posthospital adjustment.
