The Light- and Environment Project in Psychiatric Inpatient Care

Study Overview
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Brief Summary
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The care environment influences both patients' experiences of care as well as staff's experiences of the work environment. A radical change in physical environment is planned at a psychiatric ward, aiming at creating a care environment that supports patients' opportunities for recovery from mental ill-health and to create a better and more attractive work environment for the staff. The rebuilding involves a new ward layout and new innovations such as light installations, a comfort room and an activity room. The study uses a single-system design to evaluate the effects of the intervention - the rebuilt ward. Both quantitative and qualitative data will be used in the evaluation. Data will be collected using questionnaires measuring dimensions of patients' well-being and experiences of the care environment, staff's experiences of work-related stress and work environment, quality of care, a device measuring physical activity, existing clinical registers and data from medical files, staff' sick leave, participant observations, and semi-structured interviews. This evaluation study, to our knowledge the first of it's kind in Sweden, is expected to generate important knowledge of the effect of the change process that can be used at other psychiatric wards to design the inpatient care environment. In the long run, the study could lead to a better reputation of psychiatric nursing and to more attractive workplaces.

Official Title
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The Light- and Environment Project in Psychiatric Inpatient Care

Conditions
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Mental Ill-health, Care Environment, Light Installations

Intervention / Treatment
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* Other: The light and environment project in psychiatric inpatient care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Patients 18 years or older Admitted to the wards during either A phase, B phase and/or follow-up Exclusion Criteria for Patients Does not master the Swedish language well enough to complete questionnaires and participate in interviews Inclusion Criteria for Staff: Regularly employed at the ward during A and B phase and/or follow-up. Exclusion Criteria for Staff: Staff employed by the hour

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 67 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LEPPIC<br>The light and environment project in psychiatric inpatient care | Other: The light and environment project in psychiatric inpatient care<br>* Complete rebuilding of a hospital ward. The ward layout is remodeled and different devices and services are installed such as light, sound, and color settings, increased opportunities for physical activity, social harmony, privacy, peace, and quiet. A comfort room and a activity room will be built.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Outcome Rating Scale [patients] | The Outcome Rating Scale measures self-assessed satisfaction with life on four visual-analogue scales. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Perceived stress [staff] | PSS consists of 10 items answered on a 5-point Likert scale | Changes during baseline and intervention period (measured regularly for 12 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of interactions [patients] | This is measured using The Caring Professional Scale (CPS) that consists of 14 items answered on a 5-point Likert scale. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Anxiety and depressive symptoms [patients] | The Hospital Anxiety and Depression Scale (HAD) will be used to measure anxiety and depressive symptoms. All items are scored on a 4-point scale. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Quality in psychiatric care [patients] | The QPC-IP measures quality of care on 30 items using a 4-point scale. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Stress of Conscience [staff] | The Stress of Conscience Questionnaire (SCQ) will be used to measure the frequencies of stressful situations and the degree to which these lead to stress of conscience among staff. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Quality of care [staff] | The Quality in Psychiatric Care- Inpatient Staff (QPC-IPS) questionnaire will be used to measure quality of care. | Changes during baseline and intervention period (measured regularly for 12 weeks) | 
| Physical activity [patients and staff] | An electronic device measuring physical activity will be carried by participants during one week before and after rebuilding the ward. | Changes in physical activity between baseline and intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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work environment, mixed methods, single-system-design, psychiatric inpatient care, rebuilding