Effects of orientation program on psychiatric patients attitude toward the hospital

Patients newly admitted to a psychiatric unit of a general hospital were studied to determine if a specific orientation program provided by a psychiatric nurse would improve their attitudes toward the hospital. If this was accomplished it was anticipated that the patient would respond more favorable to his care. Incoming patients were placed alternately into a control and experimental group. The sample consisted of 33 females and 27 males ranging in age from ten to seventy-eight years. The investigator provided a specific orientation to the experimental group and the regular hospital admission procedure was given by the hospital staff to the control group. The semantic differential technique as developed Osgood and his collaborators was used to measure attitudes. The concepts hospital, doctor, and nurse were rated on twenty five bi-polar scales. Numerical values from one to seven were given in the scales. The scores were summed to produce an attitude score for each patient and each concept. The scales were administered to each group at the time of admission and twenty four hours later. The specific orientation was given to the experimental group immediately following the administration of the first test and continued for one-half hour, twenty four hours later. The mean difference between test and re-test for each concept and each group was calculated. T-tests were made to determine if the mean difference in scores between the two test for the experimental and control group were significantly different. The results revealed there were no statistically reliable changes in attitudes toward the three concepts in a more favorable direction. Five highly evaluative scales were removed from the original 25 scales and the mean attitude scores found on each concept for the experimental and control group. The mean difference between test and re-test was computed for each concept and each group. T-tests were made to determine if the mean differences between the two tests were reliably different. The t-test for the mean difference indicated a reliable positive change in attitude only for the concept nurse for the experimental group. Unexpectedly the scores were quite positive. Patients' verbal and non-verbal responses, during the orientation, however, did not coincide with these results. These responses indicated much anxiety around their illness, treatment, and treatment outcomes. They were in many instances worried about their family and employment. The attitude toward the hospital seems to be separate from these feelings. The attitude toward the physician was quite favorable on the first test and changed a little on re-test. Patients generally seem to feel positively toward their doctor. The concept nurse changed toward a more favorably attitude on re-test. The t-test for the mean difference between the experimental and control groups on five evaluative scales showed a significant statistical change. Psychiatric nursing intervention seems to be helpful to the patient in his adjustment to the hospital, and hopefully to his response to treatment. While the concept hospital did not change significantly in a more favorable direction, the concept nurse did. There seems to be a more favorable attitude change toward the nurse on the re-test. The investigator believes it is desirable to plan orientation programs for newly admitted patients. The positive change toward the concept nurse indicates that the patient might benefit most from the program when people who carry out the orientation have necessary knowledge and skills to focus the procedure upon the patient and his needs and respond as indicated in assisting him to become acquainted with the hospital.