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Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Emergency primary care personnel’s perception of professional-patient interaction in aggressive incidents -- a qualitative study

Authors: Tone Morken, Kjersti Alsaker, Ingrid H. Johansen

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

Incidents of aggression and violence from patients and visitors occur in emergency primary care. Most previous studies have focused on risk factors such as characteristics of patient, health personnel or situation. This study aimed to explore professional-patient interaction in aggressive situations.

Methods

A focus group study with eight focus groups was performed, including a total of 37 nurses and physicians aged 25–69 years. The participants were invited to talk about their experiences of violence in emergency primary care. Analysis was conducted by systematic text condensation. Results were then illuminated by Honneth’s theory The Struggle for Recognition.

Results

We identified three main themes regarding the interaction between health personnel and patients or visitors in aggressive situations: (1) unmet needs, (2) involuntary assessment, and (3) unsolicited touch. In all interactions the aggressive behaviour could be understood as a struggle for recognition.

Conclusions

Aggression is more likely to arise in situations where the patients’ needs or personal borders are invalidated. The struggle for personal recognition during the interaction between patient and health professionals should be addressed in health professionals’ education. This knowledge might increase their awareness and help them to react in a more expedient manner.
Literature
1.
2.
go back to reference Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. General practitioners’ assessment of risk of violence in their practice: results from a qualitative study. J Eval Clin Pract. 2008;14:385–90.CrossRefPubMed Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. General practitioners’ assessment of risk of violence in their practice: results from a qualitative study. J Eval Clin Pract. 2008;14:385–90.CrossRefPubMed
3.
go back to reference Tolhurst H, Baker L, Murray G, Bell P, Sutton A, Dean S. Rural general practitioner experience of work-related violence in Australia. Aust J Rural Health. 2003;11:231–6.PubMed Tolhurst H, Baker L, Murray G, Bell P, Sutton A, Dean S. Rural general practitioner experience of work-related violence in Australia. Aust J Rural Health. 2003;11:231–6.PubMed
4.
go back to reference Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. Violence in general practice: perceptions of cause and implications for safety. Can Fam Physician. 2008;54:1278–84.PubMedPubMedCentral Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. Violence in general practice: perceptions of cause and implications for safety. Can Fam Physician. 2008;54:1278–84.PubMedPubMedCentral
5.
go back to reference Koritsas S, Coles J, Boyle M, Stanley J. Prevalence and predictors of occupational violence and aggression towards GPs: a cross-sectional study. Br J Gen Pract. 2007;57:967–70.CrossRefPubMedPubMedCentral Koritsas S, Coles J, Boyle M, Stanley J. Prevalence and predictors of occupational violence and aggression towards GPs: a cross-sectional study. Br J Gen Pract. 2007;57:967–70.CrossRefPubMedPubMedCentral
6.
go back to reference Hills DJ, Joyce CM. Personal, professional, and work factors associated with Australian clinical medical practitioners’ experiences of workplace aggression. Ann Occup Hyg. 2013;57:898–912.PubMed Hills DJ, Joyce CM. Personal, professional, and work factors associated with Australian clinical medical practitioners’ experiences of workplace aggression. Ann Occup Hyg. 2013;57:898–912.PubMed
7.
go back to reference Whittington R, Richter D. From the individual to the interpersonal: environment and interaction in the escalation of violence in mental health settings. In: Richter D, Whittington R, editors. Violence in mental health settings: causes, consequences, management. New York: Springer; 2006. p. 47–68.CrossRef Whittington R, Richter D. From the individual to the interpersonal: environment and interaction in the escalation of violence in mental health settings. In: Richter D, Whittington R, editors. Violence in mental health settings: causes, consequences, management. New York: Springer; 2006. p. 47–68.CrossRef
8.
go back to reference Lawrence C, Leather P. The social psychology of violence and aggression. In: Leather P, Brady C, Lawrence D, Beale D, editors. Work-related violence: assessment and intervention. London: Routledge; 1999. Lawrence C, Leather P. The social psychology of violence and aggression. In: Leather P, Brady C, Lawrence D, Beale D, editors. Work-related violence: assessment and intervention. London: Routledge; 1999.
9.
go back to reference Cox T, Leather P. The prevention of violence at work: application of a cognitive behavioural theory. In: Cooper CL, Robertson IT, editors. International review of industrial and organizational psychology. Oxford: Wiley; 1994. p. 213–45. Cox T, Leather P. The prevention of violence at work: application of a cognitive behavioural theory. In: Cooper CL, Robertson IT, editors. International review of industrial and organizational psychology. Oxford: Wiley; 1994. p. 213–45.
10.
go back to reference Winstanley S, Whittington R. Aggressive encounters between patients and general hospital staff: Staff perceptions of the context and assailants’ levels of cognitive processing. Aggress Behav. 2004;30:534–43.CrossRef Winstanley S, Whittington R. Aggressive encounters between patients and general hospital staff: Staff perceptions of the context and assailants’ levels of cognitive processing. Aggress Behav. 2004;30:534–43.CrossRef
11.
go back to reference Winstanley S, Whittington R. Violence in a general hospital: comparison of assailant and other assault-related factors on accident and emergency and inpatient wards. Acta Psychiatr Scand Suppl. 2002;412:144–7.CrossRef Winstanley S, Whittington R. Violence in a general hospital: comparison of assailant and other assault-related factors on accident and emergency and inpatient wards. Acta Psychiatr Scand Suppl. 2002;412:144–7.CrossRef
12.
13.
go back to reference Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. (2015) [Epub ahead of print]. Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. (2015) [Epub ahead of print].
14.
go back to reference Malterud M. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40:795–805.CrossRefPubMed Malterud M. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40:795–805.CrossRefPubMed
15.
go back to reference Honneth A. The struggle for recognition: the moral grammar of social conflicts. 1st MIT Press ed. Cambridge: Mass; 1996 Honneth A. The struggle for recognition: the moral grammar of social conflicts. 1st MIT Press ed. Cambridge: Mass; 1996
16.
go back to reference Høilund P, Juul S. Anerkendelse og dømmekraft i socialt arbejde [recognition and judgement in social work]. Copenhagen: Hans Reitzels Forlag; 2005. Høilund P, Juul S. Anerkendelse og dømmekraft i socialt arbejde [recognition and judgement in social work]. Copenhagen: Hans Reitzels Forlag; 2005.
17.
go back to reference Giesen P, Mokkink H, Hensing M, van den Bosch W, Grol R. Rude or aggressive patient behaviour during out-of-hours GP care: challenges in communication with patients. Patient Educ Couns. 2008;73:205–8.CrossRefPubMed Giesen P, Mokkink H, Hensing M, van den Bosch W, Grol R. Rude or aggressive patient behaviour during out-of-hours GP care: challenges in communication with patients. Patient Educ Couns. 2008;73:205–8.CrossRefPubMed
18.
go back to reference El-Gilany AH, El-Wehady A, Amr M. Violence against primary health care workers in Al-Hassa, Saudi Arabia. J Interpers Violence. 2010;25:716–34.CrossRefPubMed El-Gilany AH, El-Wehady A, Amr M. Violence against primary health care workers in Al-Hassa, Saudi Arabia. J Interpers Violence. 2010;25:716–34.CrossRefPubMed
19.
go back to reference Hills D, Joyce C. A review of research on the prevalence, antecedents, consequences and prevention of workplace aggression in clinical medical practice. Aggress Violent Behav. 2013;18:554–69.CrossRef Hills D, Joyce C. A review of research on the prevalence, antecedents, consequences and prevention of workplace aggression in clinical medical practice. Aggress Violent Behav. 2013;18:554–69.CrossRef
20.
go back to reference Carlsson G, Dahlberg K, Drew N. Encountering violence and aggression in mental health nursing: a phenomenological study of tacit caring knowledge. Issues Ment Health Nurs. 2000;21:533–45.CrossRefPubMed Carlsson G, Dahlberg K, Drew N. Encountering violence and aggression in mental health nursing: a phenomenological study of tacit caring knowledge. Issues Ment Health Nurs. 2000;21:533–45.CrossRefPubMed
21.
go back to reference Gudde CB, Olsø TM, Whittington R, Vatne S. Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies. J Multidiscip Healthc. 2015;8:449–62.CrossRefPubMedPubMedCentral Gudde CB, Olsø TM, Whittington R, Vatne S. Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies. J Multidiscip Healthc. 2015;8:449–62.CrossRefPubMedPubMedCentral
22.
go back to reference Hodge AN, Marshall AP. Violence and aggression in the emergency department: a critical care perspective. Aust Crit Care. 2007;20:61–7.CrossRefPubMed Hodge AN, Marshall AP. Violence and aggression in the emergency department: a critical care perspective. Aust Crit Care. 2007;20:61–7.CrossRefPubMed
23.
go back to reference Winstanley S. Cognitive model of patient aggression towards health care staff: the patient’s perspective. Work Stress. 2005;19:340–50.CrossRef Winstanley S. Cognitive model of patient aggression towards health care staff: the patient’s perspective. Work Stress. 2005;19:340–50.CrossRef
24.
go back to reference Whittington R, Wykes T. Aversive stimulation by staff and violence by psychiatric patients. Br J Clin Psychol. 1996;35:11–20.CrossRefPubMed Whittington R, Wykes T. Aversive stimulation by staff and violence by psychiatric patients. Br J Clin Psychol. 1996;35:11–20.CrossRefPubMed
25.
go back to reference Ilkiw-Lavalle O, Grenyer BF. Differences between patient and staff perceptions of aggression in mental health units. Psychiatr Serv. 2003;54:389–93.CrossRefPubMed Ilkiw-Lavalle O, Grenyer BF. Differences between patient and staff perceptions of aggression in mental health units. Psychiatr Serv. 2003;54:389–93.CrossRefPubMed
26.
go back to reference Duxbury J, Whittington R. Causes and management of patient aggression and violence: staff and patient perspectives. J Adv Nurs. 2005;50:469–78.CrossRefPubMed Duxbury J, Whittington R. Causes and management of patient aggression and violence: staff and patient perspectives. J Adv Nurs. 2005;50:469–78.CrossRefPubMed
Metadata
Title
Emergency primary care personnel’s perception of professional-patient interaction in aggressive incidents -- a qualitative study
Authors
Tone Morken
Kjersti Alsaker
Ingrid H. Johansen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0454-7

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