ABSTRACT
OBJECTIVES: This study was designed to compare the ward atmosphere of an open ward and that of a closed ward as perceived by chronic schizophrenic patients, and to and out whether the perceived ward atmosphere is associated with their quality of life, and also to get some practical suggestions for treatment policies of open wards. METHODS: Fifty-two chronic schizophrenic inpatients were selected, 26 of them were in an open ward and the remaining 26 patients were in a closed ward, in Seoul National Mental Hospital. All the patients were asked to answer the whole items of Ward Atmosphere Scale (WAS) and SCL-90-R. Objective indicators and subjective indicators of their quality of life were scored during a face to face interview using portions of Lehman's Quality of Life Interview. The subjective indicators of quality of life were combined to a single 'global quality-of-life score' and then examined for associations with other variables. All the measures were compared between the two groups. Covariate adjustments were made as needed. RESULTS: The open ward patients reported significantly higher scores on 'support', 'autonomy' and 'practical orientation' subscales among WAS in comparison with closed ward patients. The open ward patients reported higher 'global quality-of-life score' compared with the closed ward patients. These differences were also significant following covariate adjustments for demographic, clinical and objective quality of life variables. Among the WAS subscales 'order and organization'(r=0.49, p <.05) was the highest correlate of 'globol quality-of-life score' in case of open ward patients, and 'support'(r=0.59, p<.01) was the highest correlate in case of closed ward patients. CONCLUSION: The open ward patients reported better satisfaction with life, and their reported satisfaction were associated with their higher ratings on WAS.
Subject(s)
Humans , Atmosphere , Hospitals, Psychiatric , Inpatients , Quality of Life , SeoulABSTRACT
Changes of blood pressure, heart rate, ECG, respiration rate and pupil size by intracerebroventricular(ICV) infusion of hypertonic NaCl with 0.04 ml/min for 5 min(total 0.2ml) were observed in urethane-anesthetized rabbits. ICV infusion of 0.75M NaCl produced slight pressor effect (11mmHg) and did not affect other parameters. ICV infusion of 1.5M NaCl began to increase blood pressure from 2~3 min after the infusion and produced maximal increase(24mmHg) at 5~10 min. Then the pressor effect was recovered to the original level at 30~60 min. Change of heart rate by the infusion was not clear, but ST-segment of ECG was markedly depressed. Respiration rate increased about 1.5 times than the control in accordance with the pressor effect and the state was continued even after the recover of the pressor effect. Both pupils dilated markedly and light-reflex was lost. Changes of parameters by ICV infusion of 3.0M NaCl were similar to those by 1.5M NaCl and some rabbits caused severe arrhythmias and died. The purpose of present study is to investigate the mechansim(s) of the pressor effect induced by the ICV infusion of 1.5M NaCl. The pressor effect of 1.5M NaCl was attenuated by the continuous infusion of vasopressin antagonist(20microm/kg/min) but not affected by intravenous treatment with 2mg/kg phentolamine, 2mg/kg propranolol and 1mg/kg chlorisondamine. The pressor effect was not altered with ICV 0.12mg/kg phenoxybenzamine, 0.4mg diltiazem, 0.1mg/kg mecamylamine and 0.2mg/kg atropine. After ICV infusion of 25microg/kg/min of diazepam, however, the pressor effect was completely abolished and restored 3~4 hours after stopping diazepam infusion. The pressor effect was rather potentiated than inhibited in bilateral adrenalectomized or nephrectomized rabbits. Infusion of 2microg/kg/min of saralasin for 10 min in the bliateral adrenalectomized rabbit did not affect the pressor effect at all. These results suggest that hypertensive effect induced by ICV infusion of hypertonic NaCl is mediated by the increase of vasopressin secretion.