Skip to main content
Top
Published in: Administration and Policy in Mental Health and Mental Health Services Research 5/2016

01-09-2016 | Original Article

Well-Being and Safety Among Inpatient Psychiatric Staff: The Impact of Conflict, Assault, and Stress Reactivity

Authors: Erin L. Kelly, Karissa Fenwick, John S. Brekke, Raymond W. Novaco

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 5/2016

Login to get access

Abstract

Psychiatric staff are faced with multiple forms of hostility, aggression, and assault at work, collectively referred to as workplace violence, which typically is activated by patients but can also come from coworkers and supervisors. Whether workplace violence adversely affects staff well-being may be related not only to its presence, but also to an individual’s stress reactivity. At a large public psychiatric hospital, an online survey was completed by 323 clinical care staff, of whom 69.5 % had experienced physical assault in the previous 12 months. Staff well-being (depression, anger, and physical health) and staff safety concerns were adversely affected by conflicts with other staff members and by individual reactivity to social conflict and to assault. To improve staff well-being, in addition to safety protocols, interventions should target staff relationships, personal health maintenance practices, and individual coping skills for dealing with adverse workplace experiences.
Literature
go back to reference Cacioppo, J. T., Berntson, G. G., Malarkey, W. B., Kiecolt-Glaser, J. K., Sheridan, J. F., Poehlmann, K. M., et al. (1998). Autonomic, neuroendocrine, and immune responses to psychological stress: The reactivity hypothesisa. Annals of the New York Academy of Sciences, 840(1), 664–673.CrossRefPubMed Cacioppo, J. T., Berntson, G. G., Malarkey, W. B., Kiecolt-Glaser, J. K., Sheridan, J. F., Poehlmann, K. M., et al. (1998). Autonomic, neuroendocrine, and immune responses to psychological stress: The reactivity hypothesisa. Annals of the New York Academy of Sciences, 840(1), 664–673.CrossRefPubMed
go back to reference Calabrese, K. R. (2000). Interpersonal conflict and sarcasm in the workplace. Genetic, Social, and General Psychology Monographs, 126, 459–494.PubMed Calabrese, K. R. (2000). Interpersonal conflict and sarcasm in the workplace. Genetic, Social, and General Psychology Monographs, 126, 459–494.PubMed
go back to reference Caldwell, M. F. (1992). Incidence of PTSD among staff victims of patient violence. Hospital & Community Psychiatry, 43, 838–839. Caldwell, M. F. (1992). Incidence of PTSD among staff victims of patient violence. Hospital & Community Psychiatry, 43, 838–839.
go back to reference Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.CrossRefPubMed Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.CrossRefPubMed
go back to reference Croker, K., & Cummings, A. L. (1995). Nurses’ reactions to physical assault by their patients. Canadian Journal of Nursing Research, 27, 81–93.PubMed Croker, K., & Cummings, A. L. (1995). Nurses’ reactions to physical assault by their patients. Canadian Journal of Nursing Research, 27, 81–93.PubMed
go back to reference Cunningham, J., Connor, D. F., Miller, K., & Melloni, R. H, Jr. (2003). Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities. Aggressive Behavior, 29, 31–40. doi:10.1002/ab.10027.CrossRef Cunningham, J., Connor, D. F., Miller, K., & Melloni, R. H, Jr. (2003). Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities. Aggressive Behavior, 29, 31–40. doi:10.​1002/​ab.​10027.CrossRef
go back to reference Eller, N. H., Netterstrøm, B., Gyntelberg, F., Kristensen, T. S., Nielsen, F., Steptoe, A., & Theorell, T. (2009). Work-related psychosocial factors and the development of ischemic heart disease: A systematic review. Cardiology in Review, 17, 83–97. doi:10.1097/CRD.0b013e318198c8e9.CrossRefPubMed Eller, N. H., Netterstrøm, B., Gyntelberg, F., Kristensen, T. S., Nielsen, F., Steptoe, A., & Theorell, T. (2009). Work-related psychosocial factors and the development of ischemic heart disease: A systematic review. Cardiology in Review, 17, 83–97. doi:10.​1097/​CRD.​0b013e318198c8e9​.CrossRefPubMed
go back to reference Flannery, R. B, Jr, LeVitre, V., Rego, S., & Walker, A. P. (2011). Characteristics of staff victims of psychiatric patient assaults: 20-year analysis of the Assaulted Staff Action Program. Psychiatric Quarterly, 82, 11–21. doi:10.1007/s11126-010-9153-z.CrossRefPubMed Flannery, R. B, Jr, LeVitre, V., Rego, S., & Walker, A. P. (2011). Characteristics of staff victims of psychiatric patient assaults: 20-year analysis of the Assaulted Staff Action Program. Psychiatric Quarterly, 82, 11–21. doi:10.​1007/​s11126-010-9153-z.CrossRefPubMed
go back to reference Flannery, R. B, Jr, Wyshak, G., & Flannery, G. J. (2014). Characteristics of international staff victims of psychiatric patient assaults: Review of published findings, 2000–2012. Psychiatric Quarterly,. doi:10.1007/s11126-014-9314-6. Flannery, R. B, Jr, Wyshak, G., & Flannery, G. J. (2014). Characteristics of international staff victims of psychiatric patient assaults: Review of published findings, 2000–2012. Psychiatric Quarterly,. doi:10.​1007/​s11126-014-9314-6.
go back to reference French, J. R. P, Jr, Rodgers, W. L., & Cobb, S. (1974). Adjustment as person-environment fit. In G. V. Coelho, D. A. Hamburg, & J. E. Adams (Eds.), Coping and adaptation (pp. 316–333). New York: Basic Books. French, J. R. P, Jr, Rodgers, W. L., & Cobb, S. (1974). Adjustment as person-environment fit. In G. V. Coelho, D. A. Hamburg, & J. E. Adams (Eds.), Coping and adaptation (pp. 316–333). New York: Basic Books.
go back to reference Gerberich, S. G., Church, T. R., McGovern, P. M., Hansen, H. E., Nachreiner, N. M., Geisser, M. S., et al. (2004). An epidemiological study of the magnitude and consequences of work related violence: The Minnesota Nurses’ Study. Occupational and Environmental Medicine, 61, 495–503. doi:10.1136/oem.2003.007294.CrossRefPubMedPubMedCentral Gerberich, S. G., Church, T. R., McGovern, P. M., Hansen, H. E., Nachreiner, N. M., Geisser, M. S., et al. (2004). An epidemiological study of the magnitude and consequences of work related violence: The Minnesota Nurses’ Study. Occupational and Environmental Medicine, 61, 495–503. doi:10.​1136/​oem.​2003.​007294.CrossRefPubMedPubMedCentral
go back to reference Goldberg, D. P., & Williams, P. (1988). A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson. Goldberg, D. P., & Williams, P. (1988). A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson.
go back to reference Hamrin, V., Iennaco, J., & Olsen, D. (2009). A review of ecological factors affecting inpatient psychiatric unit violence: Implications for relational and unit cultural improvements. Issues in Mental Health Nursing, 30, 214–226.CrossRefPubMed Hamrin, V., Iennaco, J., & Olsen, D. (2009). A review of ecological factors affecting inpatient psychiatric unit violence: Implications for relational and unit cultural improvements. Issues in Mental Health Nursing, 30, 214–226.CrossRefPubMed
go back to reference Hardy, G. E., Shapiro, D. A., Haynes, C. E., & Rick, J. E. (1999). Validation of the General Health Questionnaire-12: Using a sample of employees from England’s health care services. Psychological Assessment, 11, 159–165. doi:10.1037/1040-3590.11.2.159.CrossRef Hardy, G. E., Shapiro, D. A., Haynes, C. E., & Rick, J. E. (1999). Validation of the General Health Questionnaire-12: Using a sample of employees from England’s health care services. Psychological Assessment, 11, 159–165. doi:10.​1037/​1040-3590.​11.​2.​159.CrossRef
go back to reference Henderson, A. D. (2003). Nurses and workplace violence: Nurses’ experiences of verbal and physical abuse at work. Nursing Leadership, 16(4), 82–98.CrossRefPubMed Henderson, A. D. (2003). Nurses and workplace violence: Nurses’ experiences of verbal and physical abuse at work. Nursing Leadership, 16(4), 82–98.CrossRefPubMed
go back to reference Ilies, R., Johnson, M. D., Judge, T. A., & Keeney, J. (2011). A within-individual study of interpersonal conflict as a work stressor: Dispositional and situational moderators. Journal of Organizational Behavior, 32, 44–64. doi:10.1002/job.677.CrossRef Ilies, R., Johnson, M. D., Judge, T. A., & Keeney, J. (2011). A within-individual study of interpersonal conflict as a work stressor: Dispositional and situational moderators. Journal of Organizational Behavior, 32, 44–64. doi:10.​1002/​job.​677.CrossRef
go back to reference Jakulj, F., Zernicke, K., Bacon, S. L., van Wielingen, L. E., Key, B. L., West, S. G., & Campbell, T. S. (2007). A high-fat meal increases cardiovascular reactivity to psychological stress in healthy young adults. The Journal of nutrition, 137(4), 935–939.PubMed Jakulj, F., Zernicke, K., Bacon, S. L., van Wielingen, L. E., Key, B. L., West, S. G., & Campbell, T. S. (2007). A high-fat meal increases cardiovascular reactivity to psychological stress in healthy young adults. The Journal of nutrition, 137(4), 935–939.PubMed
go back to reference Karasek, R., Baker, D., Marxer, F., & Theorell, T. (1981). Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. American Journal of Public Health, 71, 694–705.CrossRefPubMedPubMedCentral Karasek, R., Baker, D., Marxer, F., & Theorell, T. (1981). Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. American Journal of Public Health, 71, 694–705.CrossRefPubMedPubMedCentral
go back to reference Kelly, E. L., Subica, A. M., Fulginiti, A., Brekke, J. S., & Novaco, R. W. (2015). A cross-sectional survey of factors related to inpatient assault of staff in a forensic psychiatric hospital. Journal of Advanced Nursing, 71, 1110–1122.CrossRefPubMed Kelly, E. L., Subica, A. M., Fulginiti, A., Brekke, J. S., & Novaco, R. W. (2015). A cross-sectional survey of factors related to inpatient assault of staff in a forensic psychiatric hospital. Journal of Advanced Nursing, 71, 1110–1122.CrossRefPubMed
go back to reference Lanza, M. L. (1983). The reactions of nursing staff to physical assault by a patient. Hospital & Community Psychiatry, 34, 44–47. Lanza, M. L. (1983). The reactions of nursing staff to physical assault by a patient. Hospital & Community Psychiatry, 34, 44–47.
go back to reference Lenehan, G. P., & Turner, J. T. (1984). Treatment of staff victims of violence. In J. T. Turner (Ed.), Violence in a medical care setting: A survival guide (pp. 251–260). Rockville: Aspen Systems. Lenehan, G. P., & Turner, J. T. (1984). Treatment of staff victims of violence. In J. T. Turner (Ed.), Violence in a medical care setting: A survival guide (pp. 251–260). Rockville: Aspen Systems.
go back to reference Limm, H., Angerer, P., Heinmueller, M., Marten-Mittag, B., Nater, U. M., & Guendel, H. (2010). Self-perceived stress reactivity is an indicator of psychosocial impairment at the workplace. BMC Public Health, 10(1), 252.CrossRefPubMedPubMedCentral Limm, H., Angerer, P., Heinmueller, M., Marten-Mittag, B., Nater, U. M., & Guendel, H. (2010). Self-perceived stress reactivity is an indicator of psychosocial impairment at the workplace. BMC Public Health, 10(1), 252.CrossRefPubMedPubMedCentral
go back to reference Lion, J. R., Snyder, W., & Merrill, G. L. (1981). Underreporting of assaults on staff in a state hospital. Hospital & Community Psychiatry, 32, 497–498. Lion, J. R., Snyder, W., & Merrill, G. L. (1981). Underreporting of assaults on staff in a state hospital. Hospital & Community Psychiatry, 32, 497–498.
go back to reference Love, C. C., & Hunter, M. E. (1996). Violence in public sector psychiatric hospitals: Benchmarking nursing staff injury rates. Journal of Psychosocial Nursing and Mental Health Services, 34, 30–34.PubMed Love, C. C., & Hunter, M. E. (1996). Violence in public sector psychiatric hospitals: Benchmarking nursing staff injury rates. Journal of Psychosocial Nursing and Mental Health Services, 34, 30–34.PubMed
go back to reference Paterson, B., McComish, A., & Aitken, I. (1997). Abuse and bullying. Nursing Management (Harrow), 3(10), 8–9.CrossRef Paterson, B., McComish, A., & Aitken, I. (1997). Abuse and bullying. Nursing Management (Harrow), 3(10), 8–9.CrossRef
go back to reference Richter, D., & Berger, K. (2006). Post-traumatic stress disorder following patient assaults among staff members of mental health hospitals: a prospective longitudinal study. BMC psychiatry, 6(1), 15.CrossRefPubMedPubMedCentral Richter, D., & Berger, K. (2006). Post-traumatic stress disorder following patient assaults among staff members of mental health hospitals: a prospective longitudinal study. BMC psychiatry, 6(1), 15.CrossRefPubMedPubMedCentral
go back to reference Rossberg, J. I., Melle, I., Opjordsmoen, S., & Friis, S. (2008). The relationship between staff members’ working conditions and patients’ perceptions of the treatment environment. International Journal of Social Psychiatry, 54, 437–446. doi:10.1177/0020764008090689.CrossRefPubMed Rossberg, J. I., Melle, I., Opjordsmoen, S., & Friis, S. (2008). The relationship between staff members’ working conditions and patients’ perceptions of the treatment environment. International Journal of Social Psychiatry, 54, 437–446. doi:10.​1177/​0020764008090689​.CrossRefPubMed
go back to reference Schlotz, W., Yim, I. S., Zoccola, P. M., Jansen, L., & Schulz, P. (2011). The Perceived Stress Reactivity Scale: Measurement invariance, stability, and validity in three countries. Psychological Assessment, 23, 80–94. doi:10.1037/a0021148.CrossRefPubMed Schlotz, W., Yim, I. S., Zoccola, P. M., Jansen, L., & Schulz, P. (2011). The Perceived Stress Reactivity Scale: Measurement invariance, stability, and validity in three countries. Psychological Assessment, 23, 80–94. doi:10.​1037/​a0021148.CrossRefPubMed
go back to reference Whittington, R., & Richter, D. (2005). Interactional aspects of violent behaviour on acute psychiatric wards. Psychology, Crime & Law, 11(4), 377–388.CrossRef Whittington, R., & Richter, D. (2005). Interactional aspects of violent behaviour on acute psychiatric wards. Psychology, Crime & Law, 11(4), 377–388.CrossRef
go back to reference Yassi, A. (1994). Assault and abuse of health care workers in a large teaching hospital. Canadian Medical Association Journal, 151, 1273–1279.PubMedPubMedCentral Yassi, A. (1994). Assault and abuse of health care workers in a large teaching hospital. Canadian Medical Association Journal, 151, 1273–1279.PubMedPubMedCentral
Metadata
Title
Well-Being and Safety Among Inpatient Psychiatric Staff: The Impact of Conflict, Assault, and Stress Reactivity
Authors
Erin L. Kelly
Karissa Fenwick
John S. Brekke
Raymond W. Novaco
Publication date
01-09-2016
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research / Issue 5/2016
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-015-0683-4

Other articles of this Issue 5/2016

Administration and Policy in Mental Health and Mental Health Services Research 5/2016 Go to the issue