Inpatient aggression in mental health settings is a significant concern because it compromises the quality of care provided by health care workers. Nurses are one of the groups most affected by inpatient aggression because they are usually the client's first contact on admission. A number of studies have found that nurses are the most frequently assaulted professional group both inside and outside of the hospital setting, are more frequently assaulted than doctors and most are likely to experience some form of aggression in their career. The causes of inpatient aggression are frequently conceptualised as multidimensional and involving factors internal to the client e.g. age, factors relating to the environment such as inflexible ward routines and factors relating to the quality of the interaction between nursing staff and clients. Research studies suggest that nurses generally respond reactively and rely heavily on physical control strategies rather than on interpersonal strategies in managing inpatient aggression. Contemporary literature suggests that the perceptions nurses hold about aggression and its causes influences their management of the event and that this process is mediated by a number of client, environment and nurse-related variables including age, education, gender, nursing experience, perceptions of aggression and its causes. Although the causes and management of inpatient aggression in nursing is well documented in the United Kingdom and some other West European countries, this is not the case for Africa and in the case of this study, for Botswana. No studies have attempted to find the nurses' perception, perception on the cause, and management of inpatient aggression in Africa and more so in Botswana. Aim: The purpose of the study was to explore how nurses' demographic characteristics, their perceptions of aggression and its causes, influence the management of inpatient aggression by nurses in the main psychiatric institution in Botswana. Method: A descriptive, exploratory non-experimental design was used. Perception of inpatient aggression was captured by a Perception of Aggression Scale (POAS) and the perception on the cause and management of inpatient aggression was collected with Management of Aggression and Violence Attitude Scale (MAVAS).The sample comprised of 71 nurses, 48 of whom were females and 23 males. The mean age of the nurse respondents was 36 years. Of the 71 respondents 50 were registered nurses only while 20 were psychiatric registered nurses. More than two thirds of the respondents had a diploma in nursing, one had a masters degree and the remainder, a degree in nursing. The average nursing and psychiatric nursing experience of the respondents were 12.1 and 6.87 years respectively. ANNOVA test and t-tests were done to find the associations between the nurses' demographic variables, their perception, perception on the cause and management of inpatient aggression. Findings: The respondents In this study perceived inpatient aggression as both negative and positive. There was an overall agreement with the perception of aggression as always negative and as an action of physical violence against a nurse (81.73%). Nurses saw the cause of inpatient aggression as emanating from the internal, external and situational/interactional factors. The use of traditional methods of aggression dominated as shown by a high mean score of 80.5 as compared to interpersonal management with a mean score of 60.5. A statistical difference was found between gender, perception of aggression and perception of aggression and the traditional management of aggression while age, nursing and psychiatric nursing experience were statistically associated with the use of interpersonal management of aggression. Conclusion: The study provided insight into the nurses' perceptions, perceptions on the cause and management of inpatient aggression in a mental institution in Botswana. Nurses in this study hold predominantly negative perceptions of aggression and generally favour traditional management strategies. However, older, more experienced nurses tended to favour interpersonal techniques. Recommendations for nursing practice, education and research to address this issue centre around further and targeted education and training in mental health and specifically, in the comprehensive management of aggression which includes communication skills, use of de-escalation, use of medication and cautious physical restraint. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1989. / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

Thesis (M.A.)--Marshall University, 2003. / Title from document title page. Document formatted into pages; contains v, 33 p. Includes vita. Bibliography: p. 25-26.

Title from PDF of title page (University of Missouri--Columbia, viewed on Feb. 15, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Dissertation advisor: Dr. Martha Markward. Vita. Includes bibliographical references.

Background: The interpersonal relationship between nurses and clients is seen as the central element or core activity of mental health nursing. Without this relationship therapeutic alliance cannot take place. Concern has been expressed that nurse prescribing could have a negative impact on the nurse patient relationship and result in the nurse sacrificing nursing skills for the prescribing role. Aim: The aim of this study was to explore the nurse patient relationship in the mental health setting when the nurse is a prescriber. In order to do this a comprehensive literature review was undertaken and views of participants were explored and relationships described. Methodology and methods: Nurse prescribers were sent questionnaires to gather demographic data and basic qualitative data. Focus groups and interviews were undertaken within a large NHS Foundation Trust. A constructivist approach was used with 57 participants including nurse prescribers, pharmacist prescribers, nurse managers, clients and doctors. A discussion guide and an iterative approach were used to clarify findings. Data analysis was guided by a Framework approach. Findings: The majority of clients preferred to have their nurse prescribe for them. Trust was highly valued within the pre-established relationship and clients found nurses easier to talk to about their medication than doctors. Nurse prescribers placed high importance on being able to reduce and discontinue medication for the client, terming this ‘un-prescribing’. Nurse prescribers were uncomfortable with the concept of power, preferring to use the term ‘empowerment’. All groups of participants were unanimous that nurse prescribers continued to provide care and that they had not moved from a traditional ‘caring’ role to a ‘medical’ curing role and importance was placed on the therapeutic alliance between nurse prescribers and clients. Conclusion: Rather than detracting from the nurse patient relationship, results from this study suggest that nurse prescribing enables the mental health nurse prescriber to provide more holistic care than previously. The action of ‘un-prescribing’ may indicate a new culture around mental health nurse prescribing

Thesis (Ph. D.)--Victoria University (Melbourne, Vic.), 2006. / Includes bibliographical references.

Thesis (M.A.(Applied))--Victoria University of Wellington, 2008. / Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [108]-120).

Thesis (M.N. (Clinical)--Victoria University of Wellington, 2009. / Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 1999. / Title from document title page. Document formatted into pages; contains viii, 178 p. Vita. Includes abstract. Includes bibliographical references (p. 158-168).