الفهرس 
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Abstract
Milieu therapy can take place in a variety of inpatient and outpatient settings. In the hospital, nurses are generally the only members of the team who spend time with the clients on a 24-hour basis, and they assume responsibility for management of the therapeutic milieu. Nurses are involved in all day-to-day activities that pertain to client care. Suggestions and opinions of nursing staff are given serious consideration in the planning of care for individual clients. In the therapeutic milieu, nurses are responsible for ensuring that clients’ physiological needs are met. Clients must be encouraged to perform as independently as possible in fulfilling activities of daily living. However, the nurse must make ongoing assessments to provide assistance for those who require it. Assessing physical status is an important nursing responsibility that must not be overlooked in a psychiatric setting that emphasizes holistic care
Aim of the Study:
The aim of this study was to assess knowledge and attitudes of nurses toward concept of milieu therapy.
Research question:
This study is based on answering the following question:
• What are the knowledge of nurses toward concept of milieu therapy?
• What are nurses attitudes toward concept of milieu therapy?
Research settings:
The study was conducted at El-bbassia Hospital in El-Abbassia Mental Health Hospital in Cairo.
Subjects of the study:
It was convenient sample. The subjects of the present study included 100 nurses.
Tools of data collection:
Data were collected using the following tools:
1- Interviewing Questionnaire:
This tool was designed by the investigator in a simple Arabic language based on review of related literature. It includes three parties
Part1- socio-demographic data of nurses such as age, sex, education, marital status, and nurses’ years of experience.
Part 2- Knowledge of nurses about milieu therapy
It was developed by researcher depending on literature review. It was utilized to measure knowledge about concept of milieu therapy regarding definition, aim ,principles ,characterstics and activity therapy.It consisted of 50 “true”, “false”, or “don’t know” statements.
Part 3- MT Attitudes of nurses about milieu therapy:
It was developed by the researcher depending on literature review and based on a three point Likert scale “disagree”, ”may be” and “agree”. It is composed of two subscales: Attitudes of nurses toward therapeutic milieu in the hospital (questions 1-13) and toward psychiatric patients (questions 14-25).
Pilot study:
The pilot study was conducted on ten nurses from the hospital; those nurses were excluded from the actual study sample.
The main findings of this study revealed that:
An analysis of socio-demographic characteristics showed that that half of nurses were older than 30 years (54%), half of nurses were females, more than half of nurses have graduated from secondary school of nursing, two third of studied nurses (75%) were living in urban areas, and 56% of them had experienced more than 5 years. Slightly more than half of the sample (58%) of the studied nurses were previously participating in family therapy with patients, three quarters (80%) attended meetings in the department to discuss patients’ affairs which related to milieu therapy, patients problems and requirements, and only one third (32%) attended conferences, lectures or seminars related to the therapeutic community milieu.
• An analysis of current study illustrated that more than three quarters of studied nurses had adequate knowledge about the concept of milieu therapy and its effect on psychosocial status (85%), (80%) of the studied nurses identifying that therapeutic environment improves social relations for psychiatric patients. Whereas 9% of the sample were not aware of the aim of therapeutic milieu.
• This study explained that patients’ participation in group therapy helping them to increase independence 66% of studied nurses, also self confidence increase 76% of the studied nurses. 59% of the sample undeceives that patients could not spend enough time in group therapy, 67% of the studied nurses, participate in group therapy, unlike patients who are not participating regularly in group therapy 63%of the sample. Many patients with different diagnosis are included in group therapy80% of the studied nurses.
• An analysis of nurses Attitude results illustrated that 49%of of the studied nurses do not agree that environmental hospital is similar to the home environment, they have positive attitudes toward patient participation in group therapy (76%).
• Association between Socio-demographic characteristics of the participating nurses and their attitude describes that the studied socio-demographic factors, only years of experience variable was related to nurses’ attitude, and nurses with long years of experience were more likely to have a positive attitude (p<0.05).
• Association between knowledge of the participating nurses and their attitude demonstrates that nurses with satisfactory knowledge were more likely to have a positive attitude towards the therapy (p<0.05).