ArticleBMJ open2023
Staff and ward factors associated with aggression development on an acute closed psychiatric ward: an experience sampling method study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Association Between Nurse Staffing and Conflict and Containment in Acute Mental Health Care: A Systematic Review.International journal of mental health nursing · 2025Pooled it
- Workplace Violence Prevention in Forensic Psychiatric Nursing: A Five-Year Qualitative Content Analysis of Incident Reports From a Finnish Forensic Psychiatric Hospital.Journal of psychiatric and mental health nursing · 2026Article
- Article
- Prevention of Violence in an Acute Psychiatric Unit: Spanish Validation of the Brøset Violence Checklist and Assessment of Its Predictive Capacity for Physical Restraint.Journal of psychiatric and mental health nursing · 2025Article
- Digital-based emergency prevention and control system: enhancing infection control in psychiatric hospitals.BMC medical informatics and decision making · 2025Article
- Professional and personal experiences of workplace violence among Italian mental health nurses: A qualitative study.AIMS public health · 2024Article
- Reducing violence and aggression: a quality improvement project for safety on an acute mental health ward.BMJ open quality · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aggression on psychiatric wards develops under influence of patient, staff and ward factors. Assessment of naturalistic derived staff and ward factors might increase better understanding of how aggressive incidents develop on psychiatric wards.
objectiveStudying staff and ward factors including interactions between patients and nurses prior and after development of aggression, within a naturalistic closed ward setting.
designA prospective naturalistic experience sampling method (ESM) study. SETTING AND
participantsA high intensive care unit of a mental health institution in The Netherlands where 29 nurses answered beeps generated by an app during approximately 7 consecutive days with questions regarding their subjective feelings, ward atmosphere, location, interaction they had with patients and their colleagues and whether an incident took place.
main outcome measuresAssociations were established between different staff and ward factors and the occurrence of aggressive incidents on the ward.
resultsRisk for aggression was associated with the nurse being with a patient (OR=2.26, 95% CI 0.99 to 5.15, p=0.05). No significant association was found between discussing with the patient and setting a limit or physical absence of the nurse on the one hand and aggression on the other. More experienced nurses encountered more aggression (OR=3.5, 95% CI 1.32 to 8.26, p=0.01). Age and gender of the nurse were not associated with aggression development. Exceeding the maximum bed capacity was associated with a greater risk for aggression (OR=5.36, 95% CI 1.69 to 16.99, p=0.004). There was no significant association when analysing a more positive atmosphere on the ward or positive affect of the nurse, but negative affect of the nurses showed a trend for an association with less aggression.
conclusionAggression is a problem that should be managed from a multidimensional perspective. The quality of interaction between nurses and patients is crucial. Exceeding the maximum bed capacity is likely associated with more aggression.
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