Patient-staff conflict: results of a survey on acute psychiatric wards.
BACKGROUND
Disruptive behaviours of acute psychiatric inpatients have typically been studied separately, as have the methods used to contain them. There are indications that behaviours and containment methods are systematically related.


OBJECTIVE
The aim of this study was to assess the frequency and relationship between the differing conflict behaviours of patients, and explore the relationship between professional containment measures and those conflict behaviours.


METHODS
A cross-sectional survey of conflict behaviours and containment of 238 two-week admissions to 12 acute psychiatric wards in London, UK was carried out.


RESULTS
Factor analysis revealed seven patterns of conflict behaviours, with aggression being separately associated with absconding and medication refusal. Neither substance misuse nor self-harm were associated with aggression. Aggressive behaviour attracted the widest range of containment measures, including the use of special observation.


CONCLUSIONS
The conflict behaviours of patients form complex patterns, and should be studied together rather than separately.
Bowers
Len
L
St Bartholomew School of Nursing and Midwifery, City University, Philpot Street, London E1 2EA, UK. L.Bowers@city.ac.uk
Simpson
Alan
A
Alexander
Jane
J
D000208:Acute Disease; D000328:Adult; D000374:Aggression; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D003625:Data Collection; D005163:Factor Analysis, Statistical; D005260:Female; D006302:Health Services Research; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D010349:Patient Compliance; D011369:Professional-Patient Relations; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders; D006113:United Kingdom / Q000453:epidemiology