The Physical and Psychosocial Environment’s Influence on Patients’ and Staff’s Perceptions of Person-Centered Care in Forensic Psychiatry

Objective: We sought to investigate the impact of the psychosocial and physical environment on patients' and staff's perceptions of the care atmosphere, quality of care and possibility to perform person-centered care at three forensic psychiatric facilities in the county of Västra Götaland in Sweden. Background: In order for a forensic psychiatric care environment to be adaptable to face the needs of the patients, a person-centered approach is needed. Person-centered care regards the patient as a person with unique experiences, desires and preferences that must be taken into account when care is provided. This requires a sufficiently flexible staff to accommodate these individual conditions and an environment adapted for individual needs. Methods: Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment, and health care professionals at the wards of the aforementioned facilities. Data were obtained by employing structured questionnaires. Results: Overall, 58 patients (72% were men) with an age range of 18 to 69 years, and 239 staff members (43% were men) with a mean age of 45 years, participated in the study. Although the staff estimated their possibility to provide person-centered care as rather high this didn´t correspond with the patients' assessment of perceived ward atmosphere as person-centered. There was a difference in assessed person-centered ward atmosphere between urban and rural facilities in favor of the urban hospital (p<0.01). Conclusion: The results of this study indicate that patients' and staff's perceptions of person-centered care in forensic clinics are highly susceptible to factors in the physical and psychosocial environment.