The ward atmosphere scale for psychiatric inpatients with intellectual disability: a pilot study
| DOI | https://doi.org/10.1108/20441281211261159 |
| Published date | 07 September 2012 |
| Pages | 265-272 |
| Date | 07 September 2012 |
| Author | Trine Lise Bakken,Jan Ivar Røssberg,Svein Friis |
| Subject Matter | Education,Health & social care |
The ward atmosphere scale for psychiatric
inpatients with intellectual disability:
a pilot study
Trine Lise Bakken, Jan Ivar Røssberg and Svein Friis
Abstract
Purpose – Patients who have intellectual disability and mental illness will occasionally need inpatient
treatment. However,research is sparse on psychosocial factors influencing psychiatric units for patients
with intellectual disabilities. The aim of this study is to examine whether adults with intellectual disabilities
can reliably rate the Ward Atmosphere Scale – Real Ward (WAS-R).
Design/methodology/approach – A total of 17 patients with mild and moderate intellectual disability
and 21 staff members wereasked to complete the WAS-R. The authors used six subscales (involvement,
support, practical orientation, order and organisation, angry and aggressive behaviour, and staff
control) that have proved to be of major importance for patient satisfaction and treatment outcome to
measure the patients’ and the staff members’ perceptions of the treatment milieu. Toexamine the internal
consistency Cronbach’s alpha was calculated for the patient and staff scores, respectively.
Findings – A total of 16 patients completed the form. Patients with mild intellectual disabilities were able
to answer the WAS with some help, whereas patients with moderate intellectual disabilities had major
difficulties with understanding more than half of the WAS items. These difficulties were also reflected in
the internal consistency scores. Cronbach’s alpha was satisfactory ($0.50) for five subscales for
patients with mild intellectual disabilities, but only satisfactory for two of the six subscales for patients
with moderate intellectual disabilities.
Research limitations/implications – A replication study should use a shorter version of the WAS-R,
and family or caregivers should answer the WAS-R additionally to the patients.
Originality/value – This study may encourage more research on treatment milieu for patients with
intellectual disability and mental illness.
Keywords Intellectual disability, Learning disabilities, Adults, Mental illness, Ward Atmosphere Scale,
Treatment environment
Paper type Research paper
Introduction
The treatment environment is as an important factor related to both treatment outcome and
patient satisfaction for psychiatric inpatients (Friis, 1986; Eklund and Hansson, 1997;
Melle et al., 1996; Røssberg et al., 2006; Smith et al., 1996). The Ward Atmosphere Scale
(WAS) is the most commonly used instrument to measure important aspects of the treatment
environment (Moos, 1997; Røssberg and Friis, 2003). Evaluation of the ward atmosphere in
psychiatric wards treating patients with intellectual disability provides information on how the
patients and the staff experience the ward atmosphere. Studies report that there are
significant differences of perceived ward atmosphere between patients and staff members
(Friis, 1986; Røssberg and Friis, 2004). Therefore, it is impossible to conclude how patients
perceive the ward atmosphere from the staff scores only. Consequently, the main focus of
the present study was on the patient scores.
Recent studies indicate an increased risk of psychiatric disorders in clients with intellectual
disability (Smiley et al., 2007; Bakken et al., 2010). As in the general population, patients with
intellectual disability and psychiatric disorders may need inpatient treatment when they
DOI 10.1108/20441281211261159 VOL. 6 NO. 5 2012, pp. 265-272, QEmerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
PAGE 265
Trine Lise Bakken is
Researcher at the
Department for Persons
with Intellectual Disability,
Division of Psychiatry,
Oslo University Hospital,
Oslo, Norway.
Jan Ivar Røssberg is
Assistant Professor and
Svein Friis is Professor,both
at the Division of
Psychiatry/Institute of
Psychiatry, Oslo University
Hospital/University of Oslo,
Oslo, Norway.
The authors would like to thank
the patients and the staff
members in the Psychiatric
Department for Persons with
Intellectual Disability who
participated in this study and
took their time to complete the
WAS-R forms. Without their
cooperation this study would
not have been possible.
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