Turkish Psychiatric Inpatients' Perceptions of Ward Atmosphere and Associated Factors: A Cross-Sectional Study

Abstract

Ward atmosphere is a critical component of psychiatric inpatient care, shaping perceptions of safety, autonomy, therapeutic engagement, and recovery. While extensively studied internationally, little is known about patients' perceptions of ward climate in T & uuml;rkiye. This descriptive cross-sectional study was conducted with 150 adult inpatients in open psychiatric wards in Istanbul. Data were collected using a Personal Information Form and the Ward Atmosphere Scale, and analysed with descriptive statistics, Mann-Whitney U-tests, Kruskal-Wallis tests, and correlation analyses. Patients reported the highest mean score for Order and Organization and the lowest for Autonomy. Female patients scored higher on Spontaneity, whereas male patients scored higher on order and organization. Married and voluntarily admitted patients reported greater Program Clarity. Educational and diagnostic differences were also significant: primary school graduates reported higher Autonomy, secondary school graduates scored higher on Practical Orientation, and patients with schizophrenia perceived greater Autonomy compared with those with mood disorders, while patients with bipolar disorder reported higher Anger and Aggression. Age was positively correlated with Order and Organization and Program Clarity. These findings suggest that psychiatric inpatients in T & uuml;rkiye perceive their ward climate as highly structured but lacking in autonomy, and that gender, education, and diagnosis significantly shape perceptions. Psychiatric nurses play a pivotal role in enhancing ward climate. Strategies to strengthen autonomy, clarify ward routines, and implement evidence-based interventions, such as Safewards, may improve therapeutic engagement and reduce conflict.