Causes and management of aggression and violence in a forensic mental health service: Perspectives of nurses and patients

Abstract

Nurses' attitudes about the causes and management of aggression affects their choice of intervention. We aimed to compare the attitudes held by patients and staff in a forensic mental health service with the Management of Aggression and Violence Attitudes Scale, and examine the factor validity of the tool in this setting by conducting a prospective comparative questionnaire survey. Staff (n = 72) and patient (n = 98) attitudes differed to a limited extent. Confirmatory factor analysis refuted the previously reported structure of the tool. Exploratory factor analysis suggested three underlying factors related to modifiability of aggression, hands on management, and hands off management. Patients were more optimistic than nurses about the modifiability of aggressive behaviour. Male patients and those with diagnoses other than personality disorder were significantly more likely to agree about modifiability than controls. Forensic inpatients recognize the need for the use of a range of techniques to prevent and manage aggression and violence, but selected groups are most likely to believe that aggression is modifiable. Prevention and management of aggression training should emphasize the modifiability of aggressive behaviour. The development of measures of modifiability and management style would assist in the evaluation of training and would offer new avenues for research.

Reducing or Increasing Violence in Forensic Care: A Qualitative Study of Inpatient Experiences

“…They aim to describe the experience of being a patient in forensic care (e.g. Dickens et al, 2013;Gildberg, Elverdam, & Hounsgaard, 2010;Hörberg et al, 2012;Meehan et al, 2006). The aim of the present paper was to specifically examine the experiences of forensic inpatients that have decreased their risk of becoming violent in forensic care.…”

Assault experiences: Lessons learned from mental health nurses in Taiwan

“…Training courses for psychiatric staff should focus not only on strategies and skills for avoiding individual assault, but also on the importance of team cooperation in discouraging assaults and emphasizing recent evidence that some psychiatric patients believe that aggressive behaviour is modifiable by strategies, such as leaving aggressive patients alone and listening to patients more (Dickens et al . ). Because assaults are not completely preventable, we recommend that post‐incident support should be established for both staff and administrators.…”

Reliability and validity of the Management of Aggression and Violence Attitude Scale (MAVAS-BR) for use in Brazil

“…A previous study 12 evaluated the confirmatory factor analysis in a population from a forensic psychiatric service and indicated a distinct factor structure, with only three factors. This result is corroborated by the literature 17 , which supports that an instrument is valid for a specific population.…”

“…The studies that have evaluated the attitudes of nurses towards the problem are scarce, although this problem has been extensively studied in other countries [10][11][12] .…”