ArticleBMC nursing2026
Reflections by licensed practical nurses and nursing assistants on the violent behaviours of individuals receiving mental health care in an adult acute psychiatric ward: a qualitative study.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundViolence in adult acute psychiatric wards remains a significant occupational hazard for nursing staff, particularly Enrolled Nurses (equivalent to Licensed Practical Nurses) and nursing assistants who often provide direct patient care without specialized psychiatric training. Exposure to patient-perpetrated violence has serious emotional and professional consequences. This study explored and described the reflections of Licensed Practical Nurses and Nursing Assistants on the violent behaviours of individuals receiving mental health care in adult acute psychiatric wards.
methodsA qualitative, exploratory study informed by a phenomenological orientation was employed. Twenty Licensed Practical Nurses and Nursing Assistants were purposively sampled from four adult acute psychiatric wards in Limpopo Province, South Africa. Twenty participants (7 Licensed Practical Nurses and 13 Nursing Assistants) participated. Semi-structured individual interviews were conducted, audio-recorded, and analyzed using Reflective Thematic Analysis as described by Braun and Clarke. The study adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines.
resultsTwo major themes and six subthemes were identified: (1) Experiences of patient-perpetrated violence, including physical violence, verbal abuse, and destruction of ward infrastructure during routine care, which compromised safety and disrupted service delivery; and (2) Emotional impact of patient violence, encompassing fear, anger, and frustration. Participants reported frequent exposure to aggression, which significantly affected emotional well-being and professional functioning. Various coping mechanisms were employed to manage the psychological impact of working in high-risk psychiatric environments.
conclusionLicensed Practical Nurses and Nursing Assistants in adult acute psychiatric wards face significant physical and verbal violence, with profound emotional and professional consequences. These findings highlight the need for organisational interventions that prioritise trauma-informed training, structured debriefing, improved ward safety, and strengthened supervision for non-psychiatrically trained nursing staff. Addressing these systemic factors is essential for promoting staff well-being and sustaining safe therapeutic environments in psychiatric care. CLINICAL TRIAL NUMBER: Not applicable.
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