Aggression on inpatient units:Clinical characteristics and consequences

Renwick, Laoise and Stewart, Duncan and Richardson, Michelle and Lavelle, Mary and James, Karen and Hardy, Claire and Price, Owen and Bowers, Len (2016) Aggression on inpatient units:Clinical characteristics and consequences. International Journal of Mental Health Nursing, 25 (4). pp. 308-318. ISSN 1445-8330

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Abstract

Aggression and violence are widespread in UK Mental Health Trusts, and are accompa-nied by negative psychological and physiological consequences for both staff and other patients. Patients who are younger, male, and have a history of substance use and psychosis diagnoses are more likely to display aggression; however, patient factors are not solely responsible for violence, and there are complex circumstances that lead to aggression. Indeed, patient–staff interactions lead to a sizeable portion of aggression and violence on inpatient units, thus they cannot be viewed without considering other forms of conflict and containment that occur before, during, and after the aggressive incident. For this reason, we examined sequences of aggressive incidents in conjunction with other conflict and containment methods used to explore whether there were particular profiles to aggressive incidents. In the present study, 522 adult psychiatric inpatients from 84 acute wards were recruited, and there were 1422 incidents of aggression (verbal, physical against objects, and physical). Cluster analysis revealed that aggressive incident sequences could be classified into four separate groups: solo aggression, aggression–rule breaking, aggression–medication, and aggression–containment. Contrary to our expectations, we did not find physical aggression dominant in the aggression–containment cluster, and while verbal aggression occurred primarily in solo aggression, physical aggression also occurred here. This indicates that the management of aggression is variable, and although some patient factors are linked with different clusters, these do not entirely explain the variation.

Item Type:
Journal Article
Journal or Publication Title:
International Journal of Mental Health Nursing
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2900/2921
Subjects:
ID Code:
127380
Deposited By:
Deposited On:
10 Sep 2018 13:10
Refereed?:
Yes
Published?:
Published
Last Modified:
11 Jun 2020 07:06