Examining the association between ward social density and perceived homeliness in multibed psychiatric inpatient wards in southeastern Nigeria

<title>Abstract</title> <p>Psychiatric wards serve as clinical and temporary living environments for patients. While shared wards may support social interaction, it remains unclear whether higher ward social density also contributes to a home-like inpatient experience. This study examined the association between ward social density and perceived homeliness among psychiatric inpatients in selected tertiary mental healthcare facilities in southeastern Nigeria. A secondary analysis was conducted using cross-sectional questionnaire data from 123 adult inpatients across four public facilities. Ward social density was measured by the number of beds per ward, while perceived homeliness was self-reported by the patients using a single global questionnaire item. Descriptive statistics, cross-tabulation, Kruskal–Wallis test with Dunn-Holm post-hoc comparisons, and binary logistic regression were used. Perceived homeliness differed significantly across ward-density categories, H(4) = 25.32, p &lt; .001, ε² = .185. The poorest homeliness profile was concentrated in wards with 21 or more beds, while 11–15-bed and 16–20-bed wards showed stronger homeliness profiles. In the final regression model, seating-supported private interaction was significantly associated with perceived homeliness, AOR = 2.77, 95% CI [1.49, 5.14], p = .001. Findings suggest that homeliness in psychiatric wards is shaped not only by ward density but also by socially manageable, privacy-supporting spatial arrangements, even within multi-bed wards. The study highlights the need for design policies that address crowding, privacy, and controlled social interaction in low-resource psychiatric settings.</p>