2021 Volume 41 Pages 88-97
Purpose: To clarify the function of ward rules within the therapeutic framework of psychiatric hospital wards.
Methods: We conducted ethnography once a month for 6 months at 4 psychiatric wards at 3 medical institutions, and then performed qualitative inductive analysis from the theoretical perspective of structural functionalism.
Results: The “pattern of top-down administration-directed implementation of group-subordinate ward rules” functioned positively in order to ensure the continuation of a therapeutic framework based on a “closed facility environment wherein inpatients can live safely in a manner enabling peace of mind among members of the local community and psychiatric ward personnel.” The “pattern of dialog-supportive implementation of individual-oriented ward rules” functioned positively in order to ensure the continuation of a therapeutic framework in which “patients who had emerged from acute-stage psychiatric care and patients with chronic-phase conditions can receive medical care enabling them to move towards community interaction”.
Conclusion: Psychiatric ward rules served the functions of providing patients with medical care and protection, protecting members of society, and preparing patients for social rehabilitation. Our findings suggested that ward rules that support individual patients and their implementation utilizing dialog achieved the function of preparing patients for social rehabilitation.
