The impact of attire on patient approval of staff in psychiatric services: a randomised survey experiment.

Staff attire may influence patient perceptions of staff in healthcare settings. However, little is known about how this applies to psychiatric services. To address this gap, we examined whether different types of attire influence patient approval of staff in psychiatric settings.

Adult patients receiving treatment in the Psychiatric Services of the Central Denmark Region were invited to participate in an electronic survey. Respondents were randomly allocated to one of five groups shown photographs of a: I. Doctor wearing personal clothes, II. Doctor wearing white coat over personal clothes, III. Doctor wearing white coat over scrubs, IV. Nurse wearing personal clothes, or V. Nurse wearing scrubs. Each participant answered seven 'approval' question items on a Likert-like scale (range 0-10) covering competence, credibility, empathy, trustworthiness, willingness to follow recommendations, willingness to approach the staff member and perceived professionalism. Composite approval scores were compared across the doctor and nurse groups, respectively, using pairwise t-tests.

Of the 9310 eligible patients, 1431 (15.4% response rate) completed the full questionnaire. Mean composite approval scores (range 0-70) were highly similar and did not differ statistically significantly across the doctor groups (I. 52 ± 14, II. 53 ± 14 and III. 52 ± 14, respectively; all p ≥ 0.244), nor between the nurse groups (IV. 52 ± 14 and V. 52 ± 15, respectively; p = 0.826).

In this randomised survey experiment, approval ratings were highly similar across psychiatric staff attire. Given this apparent parity, and the advantages in terms of hygiene and correct identification of staff, we believe that more consistent use of uniforms should be considered.