An investigations into patients perceptions of contributing factors toward their aggressive and violent behavior after admission to a mental health Facility"

Abstract

Aggressive and violent behaviour in inpatient mental health facilities is found world-wide and is a frequent and serious clinical and nursing care problem (Duxbury, 2002:325). Despite the importance of international research findings and recommendations, it appears that patients' perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Westem Cape, in particular. It is against this background, using the theoretical framework of Duxbury (2002), that this study endeavoured to investigate the external and situational contributing to patients' aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients' perspectives. A qualitative research design was used in this study as it focused on patients' perceptions of possible contributing factors toward their aggressive and violent behaviour. A sample of 40 patients was selected from eligible patients admitted to the pre-discharged wards of Lentegeur and Valkenberg mental health facilities between January 2004 and June 2004. Data was collected by tape-recording interviews using a semi-structured interview schedule at a time acceptable to the patients. A thematic analysis was utilized according to the theoretical framework of external and situational models of possible contributing factors of inpatient aggressive and violent behaviour. The study concluded that the occurrence of aggressive and violent behaviour disrupts the therapeutic alliance. If mental health facilities want to be of optimal benefit to patients, it is required that activities should be restructured and certain nursing staff should change their attitudes. Planning and upgrading efforts require a holistic approach, obtaining and integrating input from a wide range of sector, as well as ensuring nursing staff compliance with suggested changes. Moreover, preventing and lll controlling aggressive and violent behaviour amongst inpatients should be a key innovation in the operation of all mental health facilities. Results of this study indicated that there is a need for interventions that will enable staff to deal effectively with situations that may precipitate anger and assault.