정신과 병실의 치료환경에 대한 평가 ( II ) 3개 병실환경에 대한 특성간의 비교연구

Assessment of Therapeutic Milieu of Psychiatric Wards- ( II) A Comparison Study Among T he Characteristics of 3 Different Therapeutic Milieus

The importance of milieu characteristics of psy-chiatric inpatient treatment programs has been widely recognized and a number of instruments hare been developed to measure these milieu characteristics. Amog these instruments, the Ward Atmosphere Scale (WAS), which was developed by Dr. Moos and his colleagues in the Social Ecology Laboratory at the Stanford University, is one of the most widely used and the most reliable test. In previous study of this series by the authers, the WAS proved to be applicable with the substantial reliability in Korea and useful in system atic com parisons among the different therapeutic milieus of Korea and possibly between the characteristics of American and Korean Programs. So for the next step, the authers administered the WAS to 291 subjects sampled from 3 different psychiatric inpatient wards：Custodial ward(CUW ), Medically oriented ward (MOW) and the authers’ Therapeutic community ward(TCW) to assess the characteristics of social atmospheres of several different therapeutic milieus. The authers compared these 3 different psychiatric wards：CUW , MOW and TCW and compared the subgroups according to subjects status in each therapeutic milieu：staff, student and patient and finallycom pared a Korean TCW to American Normative Sample. The results were as follows： 1. The subscale means of WAS were highest in TCW , and MOW, CUW in order. 2. According to the characteristics of Dimension of WAS, TCW was analogous to Therapeutic community program , MOW to Relationshiporiented program and CUW to Control-oriented program of Price and Moos. 3 . Patients perceived their therapeutic milieus as more restricted by staffs and more difficult to express anger and aggression openly than staffs perceived in all three psychiatric wards. And staffs saw their therapeutic milieus more positively and optimistically in TCW and more negatively and pessimistically in CUW . 4. The subsclale means of WAS were higher in a Korean TCW than American Normative Sample but anger and aggression was lower in a Korean TCW than American Normative Sample significantly.