title: Nurses' perceptions of transgressive behaviour in care relationships: a qualitative study.
abstract: OBJECTIVE
  To acquire insight into the onset and meaning of transgressive behaviour from the perspective of nurses.
  
  
  BACKGROUND
  Patient aggression towards healthcare providers occurs frequently. Nurses in particular are at risk of encountering aggressive or transgressive behaviour due to the nature, duration and intensity of relationships with patients. This study analysed nurse perspectives with regard to the onset and meaning of transgressive patient behaviour in a general hospital setting.
  
  
  METHODS
  Qualitative research according to the grounded theory method.
  
  
  METHODS
  Data were collected in 2011 through individual interviews with 18 nurses who were selected using purposive and theoretical sampling.
  
  
  RESULTS
  Findings revealed that various nurse-patient interactions can result in episodes of transgressive behaviour, depending on the interplay of determining and regulating factors which have been identified at the patient, nurse and ward level. Experiences of transgressive behaviour are influenced by degree of control nurses experience over the provision of care; the degree of patient acceptance of organizational and ward rules, the degree of gratitude and recognition expressed by the patient and the extent of patient regard for the nurse as a person. Factors affecting transgressive experiences were a trusting relationship between patient and nurse; the extent to which patient perspectives are understood; methods of managing transgressive behaviour; and the influence of the team, head nurse and ward culture and habits.
  
  
  CONCLUSIONS
  The results of this study can support the development of nurses' coping ability and self-confidence to mitigate or prevent experiences of transgressive behaviour.
authors.affiliation: University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Tina
authors.initials: T
authors.lastname: Vandecasteele
authors.affiliation: Department of Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Debyser
authors.affiliation: University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.|University Hospital Ghent, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Van Hecke
authors.affiliation: Department of Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Tineke
authors.initials: T
authors.lastname: De Backer
authors.affiliation: University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Beeckman
authors.affiliation: University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Verhaeghe
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D001291:Attitude of Health Personnel; D001530:Belgium; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D064450:Workplace Violence / Q000523:psychology*; D055815:Young Adult
keywords: aggression; care relationship; general hospital; nurse-patient relationship; nurses; nursing; qualitative research; transgressive behaviour; violence