title: Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities.
abstract: BACKGROUND
  Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment.
  
  
  OBJECTIVE
  The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour.
  
  
  METHODS
  A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality.
  
  
  METHODS
  Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability.
  
  
  RESULTS
  Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff.
  
  
  CONCLUSIONS
  From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.
authors: School of Nursing, University of the Western Cape. didier@telkomsa.net.
authors: Evalina
authors: E
authors: van Wijk
authors: Annalene
authors: A
authors: Traut
authors: Hester
authors: H
authors: Julie
mesh_terms: D000328:Adult; D000374:Aggression; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D000066550:Physical Abuse; D011369:Professional-Patient Relations; D011568:Psychiatric Nursing; D036301:Qualitative Research; D012931:Social Environment; D013019:South Africa; D055815:Young Adult