Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Queen Mary University of London, UK.
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Psychol Med. 2022 Jul;52(10):1969-1980. doi: 10.1017/S0033291720003815. Epub 2020 Oct 22.
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.
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.
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 ( = 0.003) and the availability of rooms to meet family off wards ( = 0.020).
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.
医院的建筑环境可以影响患者的治疗满意度，而治疗满意度又与关键的临床结果相关。然而，很少有研究探讨哪些因素对精神科住院患者特别重要。本研究旨在确定医院环境的哪些要素与患者对精神科住院治疗的满意度更高相关。
该研究在意大利和英国进行。通过医院访问和患者访谈收集数据。对所有医院的一般特征、精神科特定方面（患者安全、男女混合/分开病房、病房内外吸烟）和医院环境质量进行评估。使用患者治疗满意度评估量表（CAT）评估患者的治疗满意度。使用多层次模型，根据年龄、性别、教育程度、诊断和正式身份，调整 CAT 评分，探讨环境在预测 CAT 评分中的作用。
该研究纳入了 18 家精神科医院（7 家在意大利，11 家在英国）和 2130 名患者。这些国家的医疗保健系统具有关键特征（例如，国民保健制度，按地域组织的护理），但在政策监管和治理方面存在差异。有两个因素与患者更高的治疗满意度相关：男女混合病房住院（ = 0.003）和病房外有供家属会面的房间（ = 0.020）。
由于医院是最昂贵的建筑设施之一，因此其设计应基于研究证据。两个设计特点可能会提高患者的满意度：病房外的家庭房间和男女混合病房。在设计或翻新精神科设施时，应考虑这一证据。
