“But I did not touch nobody!” – Patients’ and nurses’ perspectives and recommendations after aggression on psychiatric wards: a qualitative study

Aims: To gain a deeper understanding of the differences in patients and staff per‐
spectives in response to aggression and to explore recommendations on prevention.

Design: Qualitative, grounded theory study.
Methods: We conducted semi‐structured interviews with patients and nurses in‐
volved in an aggressive incident. Data collection was performed from May 2016 ‐
March 2017.

Results: Thirty‐one interviews were conducted concerning 15 aggressive incidents.
Patients and nurses generally showed agreement on the factual course of events,
there was variation in agreement on the perceived severity (PS). Patients' recom‐
mendations on prevention were mostly personally focussed, while nurses suggested general improvements.

Conclusion: Patients are often capable to evaluate aggression and give recom‐
mendations on prevention shortly after the incident. Patients and nurses differ in
the PS of aggression. Recommendations on prevention of patients and nurses are
complementary.

Impact: What problem did the study address? Perspectives of patients and nurses
differ with respect to aggression, but how is unclear. What were the main findings?
Patients and nurses generally described a similar factual course of events concern‐
ing the incident, patients often perceive the severity less than nurses. Patients are
capable to give recommendations on prevention of aggressive incidents, shortly after the incident. Where and on whom will the research have impact? Factual course of events can be a common ground to start evaluating aggressive incidents and post‐incident review should address the severity of incidents. Asking recommendations