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Journal of clinical medicine
Par Di Lorenzo R, Mordenti F, Rubini I et 4 autres.
Contenu en anglais
Aggression in hospital settings, particularly in acute psychiatric wards, is a significant and frequent phenomenon.
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This study analyzes self- and other-directed aggressive behavior and highlights risk factors, prevention and management actions.
We divided hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena over a year based on the presence or absence of aggressive behavior. Socio-demographic and clinical variables, aggression risk assessment, modality of aggression management, Incident Reports, and harmful consequences were analyzed. The data were statistically analyzed.
The sample consisted of 411 hospitalizations and 370 inpatients, of whom 29.2% (n = 108) exhibited aggression: 3.0% (n = 11) self-directed, 23.2% (n = 86) other-directed, and 3.0% (n = 11) both types of aggression. Risk levels were found to be highly predictive of aggressive behavior. Males engaged in other-directed aggressive behavior more frequently than females, who presented more prevalent self-directed aggression (Pearson Chi2 = 13.73; p = 0.003). Adolescents more frequently engaged in both self- and other-directed aggression. Other-directed aggressive behavior occurred more frequently in unmarried people (p = 0.014), with no children (p = 0.019), in involuntary hospitalizations (p = 0.000), in longer hospitalizations (p = 0.0001), and in acute psychosis (p < 0.001), during the first days of hospitalization. The Brøset Violence Checklist showed good discrimination with high sensitivity and negative predictive value.
Assessing the level of self- and other-directed aggression risk at admission is essential for adopting appropriate preventive and management measures for patient and staff safety in a ward, avoiding coercive measures to contain aggression.
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