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Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies

BACKGROUND: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and...

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Autores principales: Gudde, Camilla Buch, Olsø, Turid Møller, Whittington, Richard, Vatne, Solfrid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599636/
https://www.ncbi.nlm.nih.gov/pubmed/26491343
http://dx.doi.org/10.2147/JMDH.S89486
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author Gudde, Camilla Buch
Olsø, Turid Møller
Whittington, Richard
Vatne, Solfrid
author_facet Gudde, Camilla Buch
Olsø, Turid Møller
Whittington, Richard
Vatne, Solfrid
author_sort Gudde, Camilla Buch
collection PubMed
description BACKGROUND: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and their respective impact. To date, only a small number of empirical studies include users’ views of relevant factors. The main objective of this review is to identify and synthesize evidence relating to service users’ experiences and views of aggressive situations in mental health settings. METHODS: We included qualitative studies of any design reporting on service users’ own experiences of conditions contributing to aggressive situations in mental health care and their views on preventative strategies. Eligible articles were identified through an electronic database search (PsycINFO, PubMed, Ovid Nursing Database, Embase, and CINAHL), hand search, and cross-referencing. Extracted data were combined and interpreted using aspects of thematic synthesis. RESULTS: We reviewed 5,566 records and included 13 studies (ten qualitative and three mixed methods). Service users recognized that both their own mental state and negative aspects of the treatment environment affected the development of aggressive situations. Themes were derived from experiential knowledge and included calls to be involved in questions regarding how to define aggression and relevant triggers, and how to prevent aggressive encounters effectively. The findings suggest that incidents are triggered when users experience staff behavior as custodial rather than caring and when they feel ignored. CONCLUSION: The findings highlight the importance of staffs’ knowledge and skills in communication for developing relationships based on sensitivity, respect, and collaboration with service users in order to prevent aggressive situations. An important factor is a treatment environment with opportunities for meaningful activities and a preponderance of trained staff who work continuously on the development of conditions and skills for collaborative interaction with users.
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spelling pubmed-45996362015-10-21 Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies Gudde, Camilla Buch Olsø, Turid Møller Whittington, Richard Vatne, Solfrid J Multidiscip Healthc Review BACKGROUND: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and their respective impact. To date, only a small number of empirical studies include users’ views of relevant factors. The main objective of this review is to identify and synthesize evidence relating to service users’ experiences and views of aggressive situations in mental health settings. METHODS: We included qualitative studies of any design reporting on service users’ own experiences of conditions contributing to aggressive situations in mental health care and their views on preventative strategies. Eligible articles were identified through an electronic database search (PsycINFO, PubMed, Ovid Nursing Database, Embase, and CINAHL), hand search, and cross-referencing. Extracted data were combined and interpreted using aspects of thematic synthesis. RESULTS: We reviewed 5,566 records and included 13 studies (ten qualitative and three mixed methods). Service users recognized that both their own mental state and negative aspects of the treatment environment affected the development of aggressive situations. Themes were derived from experiential knowledge and included calls to be involved in questions regarding how to define aggression and relevant triggers, and how to prevent aggressive encounters effectively. The findings suggest that incidents are triggered when users experience staff behavior as custodial rather than caring and when they feel ignored. CONCLUSION: The findings highlight the importance of staffs’ knowledge and skills in communication for developing relationships based on sensitivity, respect, and collaboration with service users in order to prevent aggressive situations. An important factor is a treatment environment with opportunities for meaningful activities and a preponderance of trained staff who work continuously on the development of conditions and skills for collaborative interaction with users. Dove Medical Press 2015-10-03 /pmc/articles/PMC4599636/ /pubmed/26491343 http://dx.doi.org/10.2147/JMDH.S89486 Text en © 2015 Gudde et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Gudde, Camilla Buch
Olsø, Turid Møller
Whittington, Richard
Vatne, Solfrid
Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title_full Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title_fullStr Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title_full_unstemmed Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title_short Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
title_sort service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599636/
https://www.ncbi.nlm.nih.gov/pubmed/26491343
http://dx.doi.org/10.2147/JMDH.S89486
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