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

Abstract 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 < .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.