Causes and Management of Psychiatric Inpatient Aggression and Violence: Comparison between Egyptian and Saudi Nurses’ Perspectives

Abstract

Objectives: the purpose of the current study is to investigate and compare between the Egyptian and Saudi nurses’ perspectives of causes of inpatient aggression and violence in psychiatric mental health hospitals and the different ways to manage aggression and violence. Methods: A convenience sample of 128 nurses working in three different mental health hospitals (65 Egyptians “two hospitals”, 63 Saudi “one hospital”). Participants were asked to complete the Management of Aggression and Violence Attitude Scale. An explanation about the purpose and the nature of the study was offered for each individual potential participant. Agreement to complete the questionnaire worked as an informed consent. Subjects were assured about the confidentiality of the collected data and that it will be only used by the researcher for the purpose of the current study. Data were analyzed using SPSS version 18. Results: Nurses perceived the restrictive physical environment as contributing factor to the patient aggression, manipulating this restrictive environment might help in reducing the patients’ aggression and violence. More Saudi nurses believe that physical restraint is sometimes used more than necessary (p = .003), Alternatives to the use of containment and sedation to manage patient violence could be used more frequently (p = .001), while more Egyptian nurses agreed upon prescribed medication can sometimes lead to aggression (p = .01) and that prescribed medication should be used more frequently for aggressive patients (p = .000). Findings revealed statistically significant relationship between years of experience as a psychiatric nurse and total MAVAS score, internal factors, external factors, situational factors scores (p = .000, .004, .000, .000 respectively) surprisingly, years of experience had no significant relationship with the management factor score. On the other hand the number of managed aggression/ violence cases added to the nurses opinions in relation to the management factor score as revealed in the statistically significant relationship between the two variables (p = .000). Conclusion: Psychiatric inpatient aggression and violence is commonly reported emergency that requires immediate, prompt nursing interventions to reduce and prevent its negative consequences on both patients and staff in inpatient psychiatric settings. In-service continuing educational programs concerning aggression and violence management are required to train and update nursing staff on provoking factors and proper methods of management of aggression and violence.

Keywords: aggression, violence, causes, management, mental health nursing, psychiatric nurses, inpatient psychiatry.