Patients longing for authentic personal care: a phenomenological study of violent encounters in psychiatric settings

This article focuses on patients' violence against caregivers. Several studies show that violence and threats within the health care setting are an increasing problem. Encounters that become violent have been the issue of many debates but the phenomenon is still not fully understood. It is important to understand the course of events in violent encounters, both for the sake of the patients and the caregivers' well-being. The aim of this study was to describe the essence of violent encounters, as experienced by nine patients within psychiatric care. Guided by a phenomenological method, data were analyzed within a reflective life-world approach. The findings explicate violent encounters characterized by a tension between "authentic personal" and "detached impersonal" caring. "Authentic personal" patients are encountered in an undisguised, straightforward, and open way, and they sense unrestricted respect that caregivers would show another human being. In these encounters violence does not develop well. However, in caring that is "detached impersonal," the encounters are experienced by the patients as uncontrolled and insecure. These encounters are full of risks and potential violence.