The social and therapeutic climate on general and forensic psychiatric wards with a special focus on objective and structural conditions of hospital settings

在西方国家的精神卫生运动中，精神科病房的社会气候（治疗气候，病房气氛）是一个受到广泛关注的研究问题。虽然从业者仍然意识到它的相关性，但近几十年来科学兴趣相当低。鲁道夫·穆斯的沃德大气尺度一直被认为是气候研究的黄金标准。但是，100项问卷是一个相当复杂的工具，不足以经常应用，其10个特质的概念还没有得到证实的统计手段。杜伊斯堡-埃森大学开发了一种简短的替代工具，即埃森气候评估模式。15项文书，发表在一些语言版本，评估三个气候特质：病人凝聚力，经验丰富的安全性和治疗Hold.One的病房气候研究的缺陷是，客观和结构条件的病房设置没有得到太多的关注。出版物指出了一些情况，与病房气候高度相关，如病房大小，病房功能和分配，人员配备水平，安全水平（限制）和病人周转。研究项目建议有一个双重目标：EssenCES量表在50个普通精神科病房和50个法医精神科病房的应用，允许创建涵盖精神病住院治疗的两个领域的量表手册。确定与病房环境的治疗气候最相关的客观情况和条件。参与调查将不会对精神病院造成太大压力。每个机构只能有两个到最多四个病房参加。数据收集在一个完全匿名和保密的方式，但医院可能会收到一个个人的反馈，如果管理层和病房员工agree.Substantial研究结果的病房条件和治疗气候的关系可以作为参数时，讨论精神科病房的资源和人员配置。

During the years of the mental health movement in Western countries, the social climate of psychiatric wards (therapeutic climate, ward atmosphere) was an issue of research receiving a lot of interest. Whilst practitioners still are aware of its relevance, scientific interest has been rather low in recent decades. The Ward Atmosphere Scale by Rudolph Moos has been considered a gold standard of climate research up to now. But the 100 item questionnaire is a rather complex instrument, not adequate for recurrent application, and its 10-trait-concept has not been confirmed by statistical means. A short alternative instrument was developed at the University of Duisburg-Essen, the Essen Climate Evaluation Schema (EssenCES). The 15 item instrument, published in a number of language versions, assesses three climate traits: Patients Cohesion, Experienced Safety and Therapeutic Hold.One of the deficits of ward climate research was that objective and structural conditions of a ward setting have not received too much attention. Publications indicate a number of circumstances, being highly relevant for the ward climate, like ward size, the wards function and assignment, staffing level, level of security (restriction) and patients turnover.The research project suggested has a double target: Application of the EssenCES scale on 50 general psychiatric and 50 forensic psychiatric wards, allowing creating a scale manual covering both fields of psychiatric inpatient treatment. Identification of objective circumstances and conditions most relevant for the therapeutic climate of ward settings.Participating in the survey will cause little strain to mental hospitals. Only two to maximum four wards should participate per institution. Data are collected in a completely anonymised and confidential way, but hospitals may receive an individual feedback if management and ward staff agree.Substantial findings on the relation of ward conditions and therapeutic climate may serve as arguments when discussing the resources and staffing of psychiatric wards.