Categorization of Aggressive Acts Committed by Chronically Assaultive State Hospital Patients

Quanbeck, Cameron; McDermott, Barbara E.; Lam, Chun Ho; Eisenstark, Howard; Sokolov, Gregory; Scott, Charles L.

doi:10.1176/ps.2007.58.4.521

Cited by 93 publications

(68 citation statements)

References 21 publications

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“…() found that staff–patient interactions were the most frequent antecedents to violent incidents in psychiatric inpatient settings. Staff's communication strategies in tense situations, for instance regarding limit‐setting, were often found to be ineffective in preventing conflicts from escalating (Bowers et al., ; Quanbeck et al., ). Step 2 in SESPI assesses descriptions of patients' affects in specific situations.…”

Section: Discussionmentioning

confidence: 99%

Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI): An assessment instrument of mental health nursing documentation

Myklebust

Bjørkly

2019

Nursing Open

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Aim To develop and test the reliability of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes ( SESPI ). Therapeutic nurse–patient interactions are fundamental in mental health nursing. However, little is known about how these interactions are recorded in nursing documentation and there is no instrument available for collecting this type of information for quantitative analysis. Design Instrument development and reliability testing. Methods The development of the SESPI was based on qualitative analyses of progress notes retrieved from patient records in two mental health services. A self psychological attunement perspective guided the analyses. SESPI was tested for internal consistency and inter‐rater reliability after 22 nurses independently scored 10 progress notes. Results Cronbach's alpha for the entire instrument was 0.977, indicating that the raters' scores had very high internal consistency. ICC was 0.770. The alpha and ICC values for each step were high, varying between 0.970 and 0.992.

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Section: Discussionmentioning

confidence: 99%

Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI): An assessment instrument of mental health nursing documentation

Myklebust

Bjørkly

2019

Nursing Open

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“…Bowers et al () also mentioned that interactions between patients and staff who have some decision‐making power tend to be tense and may result in aggressive action. Further, Quanbeck et al () reported that staff were most often the targets of impulsive aggression when they tried to change a patient's unwanted behaviour or refused a patient request. These perspectives might be associated with our finding that ‘staff requiring patient to take medication’ was a common provocation of ‘verbal aggression’ in AP wards.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of aggression among psychiatric inpatients by ward type in Japan: Using the Staff Observation Aggression Scale – Revised (SOAS‐R)

Sato

Noda

Sugiyama

et al. 2016

Int J Mental Health Nurs

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Aggressive behaviour by psychiatric patients is a serious issue in clinical practice, and adequate management of such behaviour is required, with careful evaluation of the factors causing the aggression. To examine the characteristics of aggressive incidents by ward type, a cross-sectional descriptive study was conducted for 6 months between April 2012 and June 2013 using the Staff Observation Aggression Scale - Revised, Japanese version (SOAS-R) in 30 wards across 20 Japanese psychiatric hospitals. Participating wards were categorized into three types based on the Japanese medical reimbursement system: emergency psychiatric, acute psychiatric, and standard wards (common in Japan, mostly treating non-acute patients). On analyzing the 443 incidents reported, results showed significant differences in SOAS-R responses by ward type. In acute and emergency psychiatric wards, staff members were the most common target of aggression. In acute psychiatric wards, staff requiring patients to take medication was the most common provocation, and verbal aggression was the most commonly used means. In emergency psychiatric wards, victims felt threatened. In contrast, in standard wards, both the target and provocation of aggression were most commonly other patients, hands were used, victims reported experiencing physical pain, and seclusion was applied to stop their behaviour. These findings suggest that ward environment was an important factor influencing aggressive behaviour. Ensuring the quality and safety of psychiatric care requires understanding the characteristics of incidents that staff are likely to encounter in each ward type, as well as implementing efforts to deal with the incidents adequately and improve the treatment environment.

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“…In a study of chronically aggressive patients, over half were under forensic commitment (Quanbeck et al . ). This result is especially important for the Finnish health‐care systems, where the state mental hospitals' main tasks are to conduct forensic mental examinations and treat criminal patients, but the most violent patients are the civil patients.…”

Section: Discussionmentioning

confidence: 97%

“…Quanbeck et al . () report on data from the United States, where half of the chronically aggressive patients (three or more assaults) were under forensic commitment. One problem in drawing conclusions between these studies is that the results are not proportioned in terms of patient days.…”

Section: Introductionmentioning

confidence: 99%

Violent behaviour in a forensic psychiatric hospital in Finland: an analysis of violence incident reports

Kuivalainen

Vehviläinen‐Julkunen

Putkonen

et al. 2013

Psychiatric Ment Health Nurs

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The aim of this paper was to explore the frequency and provocation of physically violent incidents in a Finnish forensic psychiatric hospital. Three years (2007-2009) of violent incident reports were analysed retrospectively. The data were analysed by content analysis, and statistically by Poisson regression analysis. During the study period a total of 840 incidents of physical violence occurred. Six main categories were found to describe the provocation of violence where three of these categories seemed to be without a specified reason (61%), and three represented a reaction to something (36%). The risk for violent behaviour was highest for the civil patients (RR = 11.96; CI 95% 9.43-15.18; P < 0.001), compared to criminal patients (RR = 1). The civil patients represented 36.7% of the patients, and in 43.6% of the studied patient days, they caused 89.8% of the reported violence incidents. Patients undergoing a forensic mental examination did not frequently behave aggressively (RR = 1.97; CI 95% 0.91-4.28). These results can be used in the reorganization of health-care practices and the allocation of resources.

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Categorization of Aggressive Acts Committed by Chronically Assaultive State Hospital Patients

Cited by 93 publications

References 21 publications

Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI): An assessment instrument of mental health nursing documentation

Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI): An assessment instrument of mental health nursing documentation

Characteristics of aggression among psychiatric inpatients by ward type in Japan: Using the Staff Observation Aggression Scale – Revised (SOAS‐R)

Violent behaviour in a forensic psychiatric hospital in Finland: an analysis of violence incident reports

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