Degree Name

Doctor of Philosophy


It has been recognized for decades that the ward atmosphere in which mental health care occurs has an impact on both treatment process and its outcomes. No studies have examined the perception of ward atmosphere in Arabic speaking countries and none that solely examined the perception of ward atmosphere in Jordan; therefore, the purpose of this descriptive non-experimental survey was to investigate the perceptions of ward atmosphere amongst nurses, patients and patients’ relatives in four Jordanian psychiatric hospitals. Purposive sampling was used to recruit 136 nurses, 104 patients and 27 patients’ relatives from AL-Rasheed private hospital, National Centre for Rehabilitation of Addicts (NCRA), Marka Military hospital and National Centre for Mental Health (NCMH).

The study instrument used was the Ward Atmosphere Scale (WAS) which was developed by Moos in 1968 and translated into Arabic by two bilingual translators in 2007. It measured both the Real (actual) and Ideal ward atmosphere. The data were analysed by using SPSS version 15 for windows.

The main findings of this study were that Jordanian patients and relatives were reasonably happy with the current ward atmosphere. However, Jordanian mental health nurses felt that some change was needed as they rated the three subscales of Involvement, Practical Orientation and Order and Organisation statistically significantly lower than patients and relatives. The findings also revealed that relatives and nurses rated the Ideal ward atmosphere significantly higher than patients on all subscales except Autonomy and Order and Organisation. In contrast with Western mental health facilities, comparisons were made which indicated that North American nurses rated significantly higher than the Jordanian nurses in all Real WAS subscales except Staff Control. In addition, the research indicated that North American patients rated significantly higher than the Jordanian patients in Autonomy and Practical Orientation and significantly lower than the Jordanian patients in Anger and Aggression and Staff Control as this was positively influenced by greater staff numbers.

Finally, all of the demographic variables tested in the current study were found to have no impact on the perceptions of ward atmosphere. This was true for nurses, patients and relatives but hospital ownership appeared to have an impact on ward atmosphere perceptions.

The findings of the current study conclude that it was the quality of service and the actual operational system of the hospital that directed the participants’ perceptions of ward atmosphere. In order to improve the ward atmosphere in Jordanian psychiatric hospitals, recommendations with regard to Jordanian mental health services, mental health nursing practice and mental health nursing education were made.

FoR codes (2008)

1110 NURSING, 111005 Mental Health Nursing



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.