BACKGROUND: The ward atmosphere of psychiatric care units has a major impact on treatment and satisfaction for both patients and staff. The Ward Atmosphere Scale (WAS) was developed to capture the ward atmosphere in different psychiatric settings and is a well-established instrument for this purpose. However, there is need for an update and revision of the WAS. AIM: The aim of the present study was to test a Swedish version of the revised WAS in terms of its internal consistency, content and construct validity, and usability. METHODS: Data collection took place at four psychiatric wards and 31 patients and 34 staff completed the WAS, as well as content and construct validity questions. RESULTS: Results showed that the WAS had acceptable to satisfactory internal consistency for all subscales, except for autonomy. Low correlation values between the WAS and the Good Milieu Index were obtained, against which construct validity was discussed. Results of the content validity and usability questionnaires indicate that the WAS is easy to understand and complete, but some of the items were difficult for the respondents to understand and some of the subjects were missing aspects of the physical ward environment. CONCLUSIONS: The present study confirms that the Swedish version of the revised WAS can be useful for examining the ward atmosphere in psychiatric care. However, more studies are needed in order to further test the psychometric properties of the WAS and the results of the usability questionnaire may indicate a need to use supplementary instruments in order to capture the physical ward environment as well.

BACKGROUND: The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. METHODS: 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. RESULTS: The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. CONCLUSIONS: The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

The aims of this study were to investigate (1) perceived stress as felt by the nursing staff working in psychiatric inpatient care, (2) possible differences between nurses and nurse assistants, and (3) associations among individual characteristics, the ward atmosphere, the psychosocial work environment, and perceived stress. Ninety-three members of the nursing staff completed three instruments--one each measuring perceived stress, the ward atmosphere, and the psychosocial work environment. There were no differences among the staff groups concerning perceived stress. Multivariate analysis showed that the ward atmosphere factor "Involvement" and the psychosocial work environment factor "Role Clarity" were indicators of perceived stress. Improvements in these factors could help to prevent stress among the staff.

The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff.