Abstract
AimsTo gain a deeper understanding of the differences in patients and staff perspectives in response to aggression and to explore recommendations on prevention.DesignQualitative, grounded theory study.MethodsWe conducted semi‐structured interviews with patients and nurses involved in an aggressive incident. Data collection was performed from May 2016 ‐ March 2017.ResultsThirty‐one interviews were conducted concerning 15 aggressive incidents. Patients and nurses generally showed agreement on the factual course of events, there was variation in agreement on the perceived severity (PS). Patients' recommendations on prevention were mostly personally focussed, while nurses suggested general improvements.ConclusionPatients are often capable to evaluate aggression and give recommendations on prevention shortly after the incident. Patients and nurses differ in the PS of aggression. Recommendations on prevention of patients and nurses are complementary.ImpactWhat problem did the study address? Perspectives of patients and nurses differ with respect to aggression, but how is unclear. What were the main findings? Patients and nurses generally described a similar factual course of events concerning the incident, patients often perceive the severity less than nurses. Patients are capable to give recommendations on prevention of aggressive incidents, shortly after the incident. Where and on whom will the research have impact? Factual course of events can be a common ground to start evaluating aggressive incidents and post‐incident review should address the severity of incidents. Asking recommendations from patients on how to improve safety and de‐escalation can lead to innovative and personal de‐escalation strategies and supports patients autonomy.
Highlights
Aggressive behaviour is a worldwide problem in healthcare (Gaynes et al, 2017; Rubio‐Valera et al, 2015)
Two concepts emerged from our data regarding the perspective of patients and nurses on aggressive incidents, namely facts and subjective experience
We identified perceived severity (PS) as our core category of the difference in perspectives
Summary
Aggressive behaviour is a worldwide problem in healthcare (Gaynes et al, 2017; Rubio‐Valera et al, 2015). Especially concerning per‐ spectives on the nature and cause of aggressive incidents (Duxbury & Whittington, 2005; Gillig et al, 1998; Lamanna et al, 2016) These studies lacked triangulation of different perspectives on the same incident. Omerov, Edman, and Wistedt (2004) used a questionnaire for staff members and Ilkiw‐Lavalle and Grenyer (2003) tested differences in categories from questionnaires, to compare the experiences of patients and staff of a specific ag‐ gressive incident Both found several differences in perspectives concerning causes (i.e. patients perceived environmental factors im‐ portant as cause for aggression, while staff focussed on the patient's illness) and potential prevention of the incident (i.e. inability of staff to identify patients' provocations for aggression). Further insight into similarities and differences between patients and nurses concerning recommendations is essential to use these recom‐ mendations effectively in the prevention of patient violence
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