Aggression on inpatient units: Clinical characteristics and consequences.

Area of Science:

• Psychiatry
• Mental Health Nursing
• Criminology

Background:

• Aggression and violence are prevalent in UK Mental Health Trusts, impacting staff and patients.
• Patient factors like age, gender, substance use, and psychosis are linked to aggression, but not solely responsible.
• Patient-staff interactions and preceding/subsequent conflict/containment are crucial to understanding aggression.

Purpose of the Study:

• To examine sequences of aggressive incidents alongside conflict and containment methods.
• To identify distinct profiles or patterns within aggressive incidents in inpatient psychiatric settings.

Main Methods:

• Cluster analysis of 1422 aggression incidents (verbal, physical against objects, physical).
• Study included 522 adult psychiatric inpatients across 84 acute wards.
• Analysis focused on sequences of aggression, conflict, and containment.

Main Results:

• Four clusters of aggressive incident sequences were identified: solo aggression, aggression-rule breaking, aggression-medication, and aggression-containment.
• Physical aggression was not dominant in the aggression-containment cluster as expected.
• Verbal aggression was most common in solo aggression, but physical aggression also occurred in this cluster.

Conclusions:

• Aggressive incident sequences can be categorized into distinct profiles, suggesting variable management strategies.
• While patient factors correlate with certain clusters, they do not fully explain the variation in aggression.
• Understanding the full context of aggression, including interactions and containment, is essential for effective management.