AGGRESSION IN PSYCHIATRY - A QUALITATIVE STUDY FOCUSING ON THE CHARACTERIZATION AND PERCEPTION OF PATIENT AGGRESSION BY NURSES WORKING ON PSYCHIATRIC-WARDS

The present study focuses on the characterization and perception of pa tient aggression by nurses working in a psychiatric hospital in The Ne therlands. Data have been collected by interviewing nurses working on open and closed wards. The results have been compared and related to t he existing literature on aggression. An expert panel has collaborated in the assessment of part of the research findings. Nurses perceive a nd describe aggression in different ways. Since the descriptions of ag gression varied considerably, it was not possible to formulate a gener al definition of aggression on the basis of the results of the study. Despite the fact that on the whole the general public have a negative view of aggression, the descriptions nurses gave were not always negat ive. Most of the nurses acknowledged positive as well as negative aspe cts of aggressive behaviour by patients. Interventions in cases of agg ressive behaviour depend on different factors, e.g. the individual nur se's perception of the situation, the (mostly unwritten) rules, and th e type of ward (open or closed). The same interventions are often used both to prevent aggression and to stop it. The difference lies in the moment of execution. Most interventions are aimed at stopping aggress ive behaviour by acting in a non-restrictive way, e.g. by talking to t he patient, touching the patient and giving unexpected responses. Nurs es express the belief that aggression is mainly caused by a combinatio n of patient-related, situational and interactional factors. This is n ot in accordance with the opinion of the North American Nursing Diagno sis Association, who relate aggressive behaviour mainly to patient cha racteristics.