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BMC Psychiatry

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01-12-2020 | Care | Research article

Violence rate dropped during a shift to individualized patient-oriented care in a high security forensic psychiatric ward

Authors: Ragnar Urheim, Tom Palmstierna, Knut Rypdal, Rolf Gjestad, Mette Senneseth, Arnstein Mykletun

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

Contextual variables such as staff characteristics, treatment programs, assessment routines and administrative structures are found to influence patient violence rates in psychiatric forensic wards. The possible effects of current developments in treatment philosophy emphasizing patientsˈ perspective and treatment involvement upon violence rate have not yet been examined. The aim of this paper is to analyse associations between such developments and the occurrence of violent incidents among patients in a high security forensic psychiatric ward.

Methods

During a 17-year period with stable ward conditions, incidents of violence were systematically collected together with diagnostic, risk assessment and demographic patient characteristics. Changes in care- and organizational related variables such as nursing staff characteristics, treatment and management routines were collected. Multilevel modelling was applied to estimate the relationship between these variables and changes in violent incidents.

Results

A substantial decline in the occurrence of violent incidents paralleled with changes in the ward during the middle phase of the study period. Most of the changes, such as implementation of new treatment and care routines and an increased proportion of female staff and higher education levels, were significantly related to a decrease in the occurrence of violent incidents in the ward.

Conclusions

Findings in this study suggest that an increase in individualized, patient-oriented care strategies, delivered by well-educated nursing staff with an equally balanced gender distribution contribute to a low level of violence.

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Title: Violence rate dropped during a shift to individualized patient-oriented care in a high security forensic psychiatric ward
Authors: Ragnar Urheim
Tom Palmstierna
Knut Rypdal
Rolf Gjestad
Mette Senneseth
Arnstein Mykletun
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Care
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02524-0

2024 ASCO Annual Meeting

Springer Medicine

Violence rate dropped during a shift to individualized patient-oriented care in a high security forensic psychiatric ward

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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