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Psychiatric Patients' Perceptions of Their Individual Treatment Program in an In-Patient Treatment Facility with an Established Therapeutic Milieu

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Psychiatric Patients' Perceptions of Their Individual Treatment Program in an In-Patient Treatment Facility with an Established Therapeutic Milieu Psychiatric patients' perceptions of their individual treatment program in an in-patient treatment facility with an established therapeutic milieu Item Type text; Thesis-Reproduction (electronic) Authors Sweeney, Linda June, 1947- Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 01/10/2021 12:50:58 Link to Item http://hdl.handle.net/10150/554830 PSYCHIATRIC PATIENTS’ PERCEPTIONS OF THEIR INDIVIDUAL TREATMENT'PROGRAM IN AN IN-PATIENT TREATMENT FACILITY WITH AN ESTABLISHED THERAPEUTIC. MILIEU by- Linda Jill Sweeney A Thesis Submitted to the Faculty of the COLLEGE OF NURSING In Partial Fulfillment of the Requirements For the Degree of 1 MASTER OF SCIENCE In the Graduate College i . THE UNIVERSITY OF ARIZONA 1 9 7 4 STATEMENT BY AUTHOR This thesis has been submitted in partial fulfill­ ment of requirements for an advanced degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. , Brief quotations from this thesis are allowable without special permission, provided that accurate acknowl­ edgment of source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the head of the major department or the Dean of the Graduate College when in his judgment the proposed use of the material is in the inter- ests of scholarship. In.. all other instances, however, permission must be obtained from the author. SJGNED: APPROVAL BY THESIS DIRECTOR This thesis has been approved on the date shown below; ftARLYS A. MOECKLY Assistant Professor of Nursing ACKNOWLEDGMENTS The author wishes to express her grateful! apprecia­ tion to each of the members of her thesis committee, as they have made a significant contribution to the development of this study by their constructive recommendations and their understanding and supportive attitudes„ The committee members are Marlys Moeckly, thesis chairman; Dr. Margarita Kay; and Helen Navin. Dr. Janelle Krueger has also been a valuable resource person. All are faculty of the College of Nursing at The University of Arizona. Many members of the staff in the Department of Psychiatry at the Arizona Medical Center, The University of Arizona, deserve special thanks for cooperating with the study and for allowing it to be conducted. The author is especially grateful to the patients who agreed to partici­ pate in the study. The author expresses her deepest appreciation to her husband, Steve, for his encouragement and unfailing co­ operation during this past year and to her son, Nathan, for enduring some periods of maternal deprivation during the progress of this study. - TABLE OF, CONTENTS Page LIST OF TABLES . , . vii LIST OF ILLUSTRATIONS ................ xii ABSTRACT ....................... xiii CHAPTER I. INTRODUCTION .................. 1 Statement of the Problem .......... 7 Significance of the Problem ........ 7 Conceptual Framework . ........... 10 II. REVIEW OF THE LITERATURE 18 III. DESIGN OF STUDY . ............ 30 Population Selection .... 30 Method of Data Collection . 31 Method of Data Analysis . , , . , . 33 IV, RESEARCH FINDINGS AND INTERPRETATION OF DATA ..................... 34 Characteristics of the Population ..... 36 Analysis of Findings 43 Specific Components of Treatment Program . 45 Most Helpful Components of Treatment Program . « . @ . @ , . 52 • Least Helpful Components of Treatment Pr og r am . @ . , . « , . , . , , * 61 Most Helpful Single Event During This Hospitalization . ... ... , . » „ . 71 Most Helpful Person (s) During This Hospitalization 72 Gains from This Hospitalization ...... 84 Suggestions for Improving the Care n ■ 7 Ejas*t ... , . .... 89 Summary of Findings „ . , . ..... 95 V TABLE OF CONTENTS— Continued Page V. SUMMARY OF THE STUDY ............ 101 Review of Findings . 103 Conclusions and Recommendations .......... 105 APPENDIX A. SUMMARY OF MILIEU THERAPY ........ 112 APPENDIX B. SUMMARY OF MILIEU THERAPY AS IT IS USED AT THE ARIZONA MEDICAL CENTER . 114 APPENDIX C. LETTER OF PERMISSION .......... 117 APPENDIX D. INITIATING THE DISCHARGE INTERVIEW . 118 APPENDIX E. STRUCTURED DISCHARGE INTERVIEW ..... 119 APPENDIX F. QUESTION #2: SPECIFIC COMPONENTS ■ OF TREATMENT PROGRAM ......... 121 APPENDIX G. QUESTION #2: SPECIFIC COMPONENTS OF TREATMENT PROGRAM CATEGORIZED . 123 APPENDIX H. QUESTION #3: MOST HELPFUL COMPONENTS OF TREATMENT PROGRAM 126 APPENDIX I. QUESTION #3: MOST HELPFUL COMPONENTS OF TREATMENT PROGRAM CATEGORIZED .......... 127 APPENDIX J, QUESTION #4: LEAST HELPFUL COMPONENTS OF TREATMENT PROGRAM 129 APPENDIX K. QUESTION #4: LEAST HELPFUL COMPONENTS OF TREATMENT PROGRAM CATEGORIZED . „ „ . 131 APPENDIX L, QUESTION #5: MOST HELPFUL SINGLE EVENT DURING THIS HOSPITALIZATION 133 APPENDIX M. QUESTION #5; MOST HELPFUL SINGLE EVENT DURING THIS HOSPITALIZATION CATEGORIZED . , „ . , . , . 135 APPENDIX N. QUESTION #6: MOST HELPFUL PERSON (S) DURING THIS HOSPITALIZATION . , . 137 vi TABLE OF CONTENTS— Continued Page APPENDIX 0. QUESTION #6: MOST HELPFUL PERSON(S) DURING THIS HOSPITALIZATION CATEGORIZED ............... 139 APPENDIX P. QUESTION #7: GAINS FROM THIS HOSPITALIZATION ............ 141 APPENDIX Q. QUESTION #7: GAINS FROM THIS HOSPITALIZATION CATEGORIZED ...... 143 APPENDIX R. QUESTION #8: SUGGESTIONS FOR IMPROVING THE CARE ON 7 EAST . 146 APPENDIX S. QUESTION #8: SUGGESTIONS FOR IMPROVING THE CARE ON 7 EAST CATEGORIZED .............. 148 v SELECTED BIBLIOGRAPHY ................ 150 LIST OF TABLES Table Page 1. Length of Hospitalization of Patients ..... 35 2. Age of Patients . , 37 3. Marital Status of Patients ........... 38 4. Religious Affiliation of Patients ....... 38 5. Highest Level,of Educational Attainment A of Patients ......... ............ 39 6. Occupation of Patients ............. 40 7. Occupation of Patient's Spouse ......... 41 8. Previous Psychiatric Treatment of P atiencs » . .. «. .. 42 9. Question #2: Total Number of Treatment Components Mentioned by Each Patient . 46 10. Question #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Recreation- Physical . „ . „ „ „ „ . ... ... 48 11. Question #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Recreation- iVI e n t a 1. .............. ... 49 12. Question #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Verbal Interaction „ „ 49 13. Question #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Creature Comforts . 50 14. Question, #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Staff Supervision . 51 vii viii LIST OF TABLES— Continued Table Page 15. Question #2: Number of Treatment Components Mentioned by Each Patient Within the Category of Diagnostic and Medical Services 52 16. Question #2: Specific Components of Treatment Program, Statistical Comparison of the Six Categories ....... 53 17. Question #3: Total Number of Most Helpful Treatment Components Mentioned by Each Patient .............. 54 18. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Recreation-Physical .............. 56 19. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Recreation-Mental . , ... » 57 20. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Verbal Interaction @ . « . « # . .- .. .... * $ .. 57 21. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Creature Comforts ....... 58 22. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Staff Supervision .................. 59 23. Question #3: Number of Most Helpful Treatment Components Mentioned by Each Patient Within the Category of Diagnostic and Medical Services ... ..... „ 60 24. Question #3: Most Helpful Treatment Components, Statistical Comparison of the Six Categories . .. , ... ..... ... 60 i ix LIST OF TABLES— Continued Table Page . 25. Question #4: Total Number of Least Helpful Treatment Components Mentioned by Each Patient ................ 62 26. Question #4: Number of Least Helpful Treatment Components Mentioned by Each Patient Within the Category of Recreation-Physical ............. 63 27. Question #4: Number of Least Helpful Treatment Components Mentioned by Each Patient Within the Category of Recreation-Mental . , . ..... , . ' 64 28. Question #4: Number of Least Helpful Treatment Components Mentioned by Each Patient Within the Category of Verbal Interaction . , . , . 65 29. Question #4: Number of Least Helpful Treatment Components Mentioned by Each Patient Within the Category of Creature Comforts . „ , „ , ....... 66 30. Question #4: Number of Least Helpful Treatment Components Mentioned, by Each Patient Within the Category of Staff Supervision .................. 66 ^ . • 31. Question #4: Number of Least Helpful Treatment Components Mentioned by Each Patient Within the Category of Diagnostic and Medical Services ......... 67 32. Question #4: Least Helpful Treatment . ^ Components,Statistical Comparison of• the Six Categories . ... ... .... 68 33. Comparison of
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