Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.

<h4>Introduction</h4>On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribu...

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Autores principales:	Irene Weltens, Maarten Bak, Simone Verhagen, Emma Vandenberk, Patrick Domen, Thérèse van Amelsvoort, Marjan Drukker
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/40f0620dcb7f4f65b5b31024d5ddda9a
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spelling	oai:doaj.org-article:40f0620dcb7f4f65b5b31024d5ddda9a2021-12-02T20:17:08ZAggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.1932-620310.1371/journal.pone.0258346https://doaj.org/article/40f0620dcb7f4f65b5b31024d5ddda9a2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258346https://doaj.org/toc/1932-6203<h4>Introduction</h4>On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards.<h4>Method</h4>In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included.<h4>Results</h4>The prevalence of aggressive behaviour on psychiatric wards varied (8-76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy.<h4>Conclusion</h4>Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.Irene WeltensMaarten BakSimone VerhagenEmma VandenberkPatrick DomenThérèse van AmelsvoortMarjan DrukkerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258346 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Irene Weltens Maarten Bak Simone Verhagen Emma Vandenberk Patrick Domen Thérèse van Amelsvoort Marjan Drukker Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
description	<h4>Introduction</h4>On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards.<h4>Method</h4>In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included.<h4>Results</h4>The prevalence of aggressive behaviour on psychiatric wards varied (8-76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy.<h4>Conclusion</h4>Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.
format	article
author	Irene Weltens Maarten Bak Simone Verhagen Emma Vandenberk Patrick Domen Thérèse van Amelsvoort Marjan Drukker
author_facet	Irene Weltens Maarten Bak Simone Verhagen Emma Vandenberk Patrick Domen Thérèse van Amelsvoort Marjan Drukker
author_sort	Irene Weltens
title	Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
title_short	Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
title_full	Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
title_fullStr	Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
title_full_unstemmed	Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
title_sort	aggression on the psychiatric ward: prevalence and risk factors. a systematic review of the literature.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/40f0620dcb7f4f65b5b31024d5ddda9a
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Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.

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