title: The impact of facility relocation on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care.
abstract: In recent years, large groups of forensic psychiatric patients have been relocated into new medium- and maximum-security forensic psychiatric facilities in Sweden, where a psychosocial care approach is embedded. From this perspective and on the assumption that physical structures affect the therapeutic environment, a prospective longitudinal study was designed to investigate the impact of the facility relocation of three forensic psychiatric hospitals on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care. Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment. Data were obtained by validated questionnaires. Overall, 58 patients (78%) answered the questionnaires at baseline with a total of 25 patients (34%) completing follow-up 1 at six months and 11 patients (15%) completing follow-up 2, one year after relocation. Approximately two-thirds of the participants at all time-points were men and their age range varied from 18 to 69. The results of this study showed that poor physical environment features can have a severe impact on care quality and can reduce the possibilities for person-centered care. Furthermore, the study provides evidence that the patients' perceptions of person-centered care in forensic psychiatric clinics are highly susceptible to factors in the physical and psychosocial environment. Future work will explore the staff's perception of ward atmosphere and the possibilities to adapt a person-centered approach in forensic psychiatric care after facility relocation.
authors.affiliation: The National Board of Forensic Medicine, Department of Forensic Psychiatry, Gothenburg, Sweden; Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Eirini
authors.initials: E
authors.lastname: Alexiou
authors.affiliation: Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Alessio
authors.initials: A
authors.lastname: Degl' Innocenti
authors.affiliation: Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Sweden.
authors.forename: Anette
authors.initials: A
authors.lastname: Kullgren
authors.affiliation: Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Quality Assurance, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: helle.wijk@gu.se.
authors.forename: Helle
authors.initials: H
authors.lastname: Wijk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005555:Forensic Psychiatry; D006778:Hospitals, Psychiatric; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011446:Prospective Studies; D011787:Quality of Health Care; D012931:Social Environment; D011795:Surveys and Questionnaires; D013548:Sweden; D055815:Young Adult
keywords: Environment; Forensic psychiatry; Person-centered care; Ward atmosphere