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Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

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  • Laura Iozzino
  • Clarissa Ferrari
  • Matthew Large
  • Olav Nielssen
  • Giovanni de Girolamo

Abstract

Background: Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards. Objectives: To use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators). Method: Systematic meta-analysis of studies published between January 1995 and December 2014, which reported rates of violence in acute psychiatric wards of general or psychiatric hospitals in high-income countries. Results: Of the 23,972 inpatients described in 35 studies, the pooled proportion of patients who committed at least one act of violence was 17% (95% confidence interval (CI) 14–20%). Studies with higher proportions of male patients, involuntary patients, patients with schizophrenia and patients with alcohol use disorder reported higher rates of inpatient violence. Conclusion: The findings of this study suggest that almost 1 in 5 patients admitted to acute psychiatric units may commit an act of violence. Factors associated with levels of violence in psychiatric units are similar to factors that are associated with violence among individual patients (male gender, diagnosis of schizophrenia, substance use and lifetime history of violence).

Suggested Citation

  • Laura Iozzino & Clarissa Ferrari & Matthew Large & Olav Nielssen & Giovanni de Girolamo, 2015. "Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0128536
    DOI: 10.1371/journal.pone.0128536
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    Cited by:

    1. Martin Salzmann-Erikson & Lilly Yifter, 2020. "Risk Factors and Triggers That May Result in Patient-Initiated Violence on Inpatient Psychiatric Units: An Integrative Review," Clinical Nursing Research, , vol. 29(7), pages 504-520, September.
    2. Martin Salzmann‐Erikson, 2018. "Using focused ethnography to explore and describe the process of nurses’ shift reports in a psychiatric intensive care unit," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(15-16), pages 3104-3114, August.
    3. In Ok Sim & Kyoung Min Ahn & Eun Jeong Hwang, 2020. "Experiences of Psychiatric Nurses Who Care for Patients with Physical and Psychological Violence: A Phenomenological Study," IJERPH, MDPI, vol. 17(14), pages 1-12, July.
    4. Suna Yalcin & Hulya Bilgin, 2019. "Risk predictions of physical aggression in acute psychiatric wards: Findings of a prospective study," Nursing & Health Sciences, John Wiley & Sons, vol. 21(3), pages 316-322, September.
    5. Fritz Frauenfelder & Theo van Achterberg & Maria Müller Staub, 2018. "Nursing diagnoses related to psychiatric adult inpatient care," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 463-475, February.
    6. Shu-Fen Niu & Shu-Fen Kuo & Hsiu-Ting Tsai & Ching-Chiu Kao & Victoria Traynor & Kuei-Ru Chou, 2019. "Prevalence of workplace violent episodes experienced by nurses in acute psychiatric settings," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-13, January.

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