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Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences

  • David P. J. Osborn (a1), Brynmor Lloyd-Evans (a1), Sonia Johnson (a1), Helen Gilburt (a2), Sarah Byford (a2), Morven Leese (a2) and Mike Slade (a2)...

Abstract

Background

Alternatives to traditional in-patient services may be associated with a better experience of admission.

Aims

To compare patient satisfaction, ward atmosphere and perceived coercion in the two types of service, using validated measures.

Method

The experience of 314 patients in four residential alternatives and four standard services were compared using the Client Satisfaction Questionnaire (CSQ), the Service Satisfaction Scale – Residential form (SSS–Res), the Ward Atmosphere Scale (WAS) and the Admission Experience Scale (AES).

Results

Compared with standard wards, service users from alternative services reported greater levels of satisfaction (mean difference CSQ 3.3, 95% CI 1.8 to 4.9; SSS–Res 11.4, 95% CI 5.0 to 17.7). On the AES, service users in alternatives perceived less coercion (mean difference –1.3, 95% CI –1.8 to –0.8) and having more ‘voice’ (mean difference 0.9, 95% CI 0.6 to 1.2). Greater autonomy, more support and less anger and aggression were revealed by WAS scores. Differences in CSQ and AES scores remained significant after multivariable adjustment, but SSS–Res results were attenuated, mainly by detention status.

Conclusions

Community alternatives were associated with greater service user satisfaction and less negative experiences. Some but not all of these differences were explained by differences in the two populations, particularly in involuntary admission.

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Copyright

Corresponding author

Dr David Osborn, Department of Mental Health Sciences, University College London, Rowland Hill Street, London NW3 2PF, UK. Email: d.osborn@medsch.ucl.ac.uk.

Footnotes

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Declaration of interest

None.

Footnotes

References

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Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences

  • David P. J. Osborn (a1), Brynmor Lloyd-Evans (a1), Sonia Johnson (a1), Helen Gilburt (a2), Sarah Byford (a2), Morven Leese (a2) and Mike Slade (a2)...

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Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences

  • David P. J. Osborn (a1), Brynmor Lloyd-Evans (a1), Sonia Johnson (a1), Helen Gilburt (a2), Sarah Byford (a2), Morven Leese (a2) and Mike Slade (a2)...
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