Aggression at the service delivery interface: Do you see what I see?

Aggression at the service delivery interface (the point of contact between service provider and service recipient) has become a focus of much recent research attention. However, much of what we know is based on cross-sectional survey data – which tells us little about the underlying dynamics within specific aggressive incidents. Further, these data are often collected from the perspective of the service provider alone. For this study, we focused on specific hostile interactions during the delivery of healthcare services and gathered data from the perspectives of service providers and service recipients. Drawing on interviews with US Department of Veterans Affairs (VA) staff and US military veterans, we categorised and compared each party's attributions for the initiation of hostile (unpleasant) encounters. We found that staff and veterans had different perspectives on the nature of precipitating factors and that the initial attribution for the event was linked to differences in subsequent responding. These findings are discussed in terms of their insight into the temporal dynamics of aggressive events and their implications for the prevention and management of hostility at the service delivery interface.