Abstract
The aim of this study was to describe cultures of three Japanese psychiatric wards, to clarify elements of the cultures, and eventually to find some suggestions on nurses' role in psychiatric ward treatment. The theoretical framework of this study was based on Bion's group theory. The participant observations were conducted on three psychiatric wards. Ward A was a rehabilitation unit in a private mental hospital, Ward B was an open unit in a general hospital and Ward C was a rehabilitation unit in a public mental hospital. Data analyses were carried on along with the data collection. Main focus of data analyses was on the ward's context. Several elements of the ward's culture were derived and reconstructed from the data in the viewpoint of the ward context and psychodynamics. The results were as follows : (1) Elements of ward culture were ward systems, the aim of the ward, shared beliefs and emotions of ward members. (2) Ward cultures were characteristically expressed by ward systems. And ward systems were created interaction between actions based ward aim and shared beliefs and emotions of the ward members. A characteristic common culture of three psychiatric wards was that wards had a system that satisfied patients' desires of dependence though both staff and patients aimed at patients' autonomy. (3) The nurse's role to create therapeutic environment was to understand ward culture prescribed by group mentality, to take the leadership and to use group dynamics to decrease anxieties of inpatients.
