The Light- and Environment Project in Psychiatric Inpatient Care (LEPPIC)

The care environment influences both patients' experiences of care as well as staff's experiences of the work environment. A radical change in physical environment is planned at a psychiatric ward, aiming at creating a care environment that supports patients' opportunities for recovery from mental ill-health and to create a better and more attractive work environment for the staff. The rebuilding involves a new ward layout and new innovations such as light installations, a comfort room and an activity room.

The study uses a single-system design to evaluate the effects of the intervention - the rebuilt ward. Both quantitative and qualitative data will be used in the evaluation. Data will be collected using questionnaires measuring dimensions of patients' well-being and experiences of the care environment, staff's experiences of work-related stress and work environment, quality of care, a device measuring physical activity, existing clinical registers and data from medical files, staff' sick leave, participant observations, and semi-structured interviews.

This evaluation study, to our knowledge the first of it's kind in Sweden, is expected to generate important knowledge of the effect of the change process that can be used at other psychiatric wards to design the inpatient care environment. In the long run, the study could lead to a better reputation of psychiatric nursing and to more attractive workplaces.

Study Overview

• Status: Completed
• Conditions: Mental Ill-health; Care Environment; Light Installations
• Intervention / Treatment: Other: The light and environment project in psychiatric inpatient care

• Study Type: Interventional
• Enrollment (Actual): 24
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Umeå, Sweden, SE-90187
    • Umeå University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 67 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria for Patients

• 18 years or older
• Admitted to the wards during either A phase, B phase and/or follow-up

Exclusion Criteria for Patients

• Does not master the Swedish language well enough to complete questionnaires and participate in interviews

Inclusion Criteria for Staff:

• Regularly employed at the ward during A and B phase and/or follow-up.

Exclusion Criteria for Staff:

• Staff employed by the hour

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: LEPPIC; The light and environment project in psychiatric inpatient care	Other: The light and environment project in psychiatric inpatient care; Complete rebuilding of a hospital ward. The ward layout is remodeled and different devices and services are installed such as light, sound, and color settings, increased opportunities for physical activity, social harmony, privacy, peace, and quiet. A comfort room and a activity room will be built.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Outcome Rating Scale [patients]	The Outcome Rating Scale measures self-assessed satisfaction with life on four visual-analogue scales.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Perceived stress [staff]	PSS consists of 10 items answered on a 5-point Likert scale	Changes during baseline and intervention period (measured regularly for 12 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of interactions [patients]	This is measured using The Caring Professional Scale (CPS) that consists of 14 items answered on a 5-point Likert scale.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Anxiety and depressive symptoms [patients]	The Hospital Anxiety and Depression Scale (HAD) will be used to measure anxiety and depressive symptoms. All items are scored on a 4-point scale.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Quality in psychiatric care [patients]	The QPC-IP measures quality of care on 30 items using a 4-point scale.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Stress of Conscience [staff]	The Stress of Conscience Questionnaire (SCQ) will be used to measure the frequencies of stressful situations and the degree to which these lead to stress of conscience among staff.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Quality of care [staff]	The Quality in Psychiatric Care- Inpatient Staff (QPC-IPS) questionnaire will be used to measure quality of care.	Changes during baseline and intervention period (measured regularly for 12 weeks)
Physical activity [patients and staff]	An electronic device measuring physical activity will be carried by participants during one week before and after rebuilding the ward.	Changes in physical activity between baseline and intervention

Collaborators and Investigators

• Sponsor: Umeå University
• Collaborators: Västerbotten County Council, Sweden
• Investigators: Principal Investigator: Britt-Marie Lindgren, Umeå University

Publications and helpful links

General Publications

• Lindgren BM, Molin J, Lundstrom M, Stromback M, Salander Renberg E, Ringner A. Does a new spatial design in psychiatric inpatient care influence patients' and staff's perception of their care/working environment? A study protocol of a pilot study using a single-system experimental design. Pilot Feasibility Stud. 2018 Dec 26;4:191. doi: 10.1186/s40814-018-0383-4. eCollection 2018.

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2017
• Primary Completion (Actual): December 31, 2020
• Study Completion (Actual): December 31, 2020

Study Registration Dates

• First Submitted: May 2, 2017
• First Submitted That Met QC Criteria: May 2, 2017
• First Posted (Actual): May 4, 2017

Study Record Updates

• Last Update Posted (Actual): October 4, 2021
• Last Update Submitted That Met QC Criteria: October 1, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Keywords: mixed methods; single-system-design; psychiatric inpatient care; work environment; rebuilding
• Other Study ID Numbers: 3500LJUSMILJO

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No