title: The influence of team members on nurses' perceptions of transgressive behaviour in care relationships: A qualitative study.
abstract: OBJECTIVE
  The aim of this study was to gain insight into the influence of team members in how nurses perceive and address patients' transgressive behaviour.
  
  
  BACKGROUND
  Aggression and transgressive behaviour in health care have been a focus of research over the past few decades. Most studies have focused on individual nurses' experiences with aggression and transgressive behaviour. Literature examining group dynamics in nursing teams and team members' interactions in handling patients' transgressive behaviour is scarce.
  
  
  METHODS
  Qualitative interview study.
  
  
  METHODS
  Seven focus-group interviews and two individual interviews were carried out in 2014-2016. Twenty-four nurses were drawn from eight wards in three general hospitals. Interviews were analysed using the constant comparative method influenced by the grounded theory approach.
  
  
  RESULTS
  While elaborating how they perceived and addressed transgressive behaviour, nurses disclosed how interactions with team members occurred. Several patterns arose. Nurses talk to one another, excuse one another, fill in for one another, warn one another and protect and safeguard one another. In these patterns in reaction to patients' transgressive behaviour, implicit group norms transpire, causing nursing teams to acquire their specific identity "as a group". Consequently, these informal group norms in nursing teams impinge how nurses feel threatened by patients' potential transgressive behaviour; gain protection from the group of nurses and conform to informal ward rules.
  
  
  CONCLUSIONS
  The findings of this study can support intervention strategies aimed at supporting nurses and nursing teams in managing patient aggression and transgressive behaviour by identifying and explicating these group dynamics and team members' interactions.
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.|Department Health care, VIVES University College, Roeselare, Belgium.
authors.forename: Tina
authors.identifier: http://orcid.org/0000-0002-5183-1088
authors.initials: T
authors.lastname: Vandecasteele
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.|University Hospital Ghent, Ghent, Belgium.
authors.forename: Ann
authors.identifier: http://orcid.org/0000-0003-3576-7159
authors.initials: A
authors.lastname: Van Hecke
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.
authors.forename: Veerle
authors.identifier: http://orcid.org/0000-0002-2973-3684
authors.initials: V
authors.lastname: Duprez
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.
authors.forename: Dimitri
authors.identifier: http://orcid.org/0000-0003-3080-8716
authors.initials: D
authors.lastname: Beeckman
authors.affiliation: Department Health care, VIVES University College, Roeselare, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Debyser
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.
authors.forename: Maria
authors.initials: M
authors.lastname: Grypdonck
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Ghent, Belgium.|Department Health care, VIVES University College, Roeselare, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Verhaeghe
mesh_terms: D000328:Adult; D000374:Aggression; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology*; D010348:Patient Care Team; D055815:Young Adult
keywords: aggression; care relationship; general hospital; nurse-patient relationship; nurses; nursing teams; qualitative research; transgressive behaviour; violence