Staff members' emotional reactions to aggressive and suicidal behavior of inpatients.

Abstract

This study examined the relationship between the characteristics of inpatients and staff members' emotional reactions to the patients, particularly the extent to which the reactions were related to patients' aggressive or suicidal behavior. The Feeling Word Checklist-58 was used to measure staff members' feelings. Two positive and five negative feeling dimensions were examined: important, confident, rejected, on guard, bored, overwhelmed, and inadequate. A total of 253 staff members from a wide variety of psychiatric wards at a university-affiliated hospital in Oslo, Norway, completed a total of 2473 checklists about their emotional reactions to 207 patients. For each patient, a member of the research team used information from ward staff who knew the patient to complete a Social Dysfunction and Aggression Scale measuring whether the patient had been aggressive (outward aggression) or suicidal (inward aggression). Staff reported positive feelings about patients much more frequently than negative feelings. Multiple regression analysis revealed that patient characteristics explained much more of the variance in negative feelings than in positive feelings. Outward aggression explained an average of 22 percent of the variance in scores on the five negative dimensions. Inward aggression explained an average of 12 percent more of the variance in scores on the five negative dimensions. Gender, age, amount of medication, and diagnosis (psychotic or not psychotic) explained only a small proportion of the variance in feeling scores. Even though the level of negative feelings toward patients was low, patients' aggressive and suicidal behavior explained a large proportion of the variance in negative feelings.