Control: patients' aggression in psychiatric settings.

Area of Science:

• Psychiatry
• Psychology
• Healthcare Management

Background:

• Psychiatric patient assaults on staff pose significant risks to individuals and healthcare organizations.
• Existing research often focuses on patient and victim characteristics, with less attention to staff perceptions of aggressive incidents.

Purpose of the Study:

• To explore how healthcare professionals' perceptions of patient aggression influence their reactions.
• To identify distinct prototypes of aggressive encounters based on staff attributions of controllability.

Main Methods:

• Conducted in-depth, semistructured interviews with 11 healthcare professionals in an Israeli psychiatric hospital.
• Utilized content analysis to identify key themes and develop encounter prototypes.

Main Results:

• Identified two primary themes: patient controllability and provider controllability over patient aggression.
• Developed four prototypes of aggressive encounters: power struggle, therapeutic encounter, inverse power relations, and victim-to-victim encounters.
• Each prototype was associated with unique emotional, cognitive, and behavioral responses from staff.

Conclusions:

• Staff perceptions of controllability significantly shape responses to patient aggression.
• Findings offer theoretical insights via attribution theory and practical implications for managing aggression in psychiatric settings.