"It’s your job, you can handle it" : a grounded theory study of ward staffs' views on the experiences, causes and consequences of verbal aggression in an acute psychiatric ward

Shetty, Prarthana (2019) "It’s your job, you can handle it" : a grounded theory study of ward staffs' views on the experiences, causes and consequences of verbal aggression in an acute psychiatric ward. Doctoral thesis, London Metropolitan University.

Abstract

Aim: The aim of the study was to investigate staff perspectives on verbal aggression. More specifically, it aimed to explore how staff experience and understand verbal aggression in an acute psychiatric ward, as well as their views on individual and organisational influences on the occurrence and maintenance of verbal aggression.

Method: Individual semi-structured interviews were conducted with eight ward staff. The transcribed interview data was analysed in accordance with the principles of constructionist grounded theory (Charmaz, 2006).

Findings: Incidents of verbal aggression were said to affect staff deeply on an emotional and psychological level. Participants described the organisational culture as one that normalised verbal aggression, and shared an awareness of an unspoken expectation that they should be able to cope with verbal aggression. Staff sought to alter their working practices to accommodate organisational expectations, which negatively influenced the staff-patient interactions, thereby perpetuating further verbally aggressive behaviour from patients.

Conclusions: The themes observed in the study have conceptualised verbal aggression as more than a negative interaction on an individual level, highlighting the influence of organisational factors as having a significant bearing on staffs’ psychological wellbeing and staff-patient relational dynamics. The clinical implications of the study are explored, followed by recommendations for future research.

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