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The study examined how nursing staff in a secure forensic unit make judgements about female patients' level of risk and whether a patient's lack of engagement in therapy was a salient factor. Results indicate that staff accounted for the following historical factors when making judgements: past aggression, substance misuse, symptoms of psychosis and personality disorder, and the following clinical factors: lack of insight, non‐compliance and lack of motivation. A positive therapeutic alliance between patient and key‐worker, high levels of self‐confidence in staff members, a supportive nursing team and an institution with good procedural security were perceived to be protective factors.

This paper aims to investigate the relationship between emotional labor and workplace violence based on the social exchange theory. Drawing on the social exchange theory, this paper aims to investigate the relationship between emotional labor and workplace violence. Specifically, the authors take a relational approach by introducing positive patient treatment as the mediator. The moderating role of organizational support in the relationship between emotional labor and workplace violence is also considered.

The data of this study encompasses 536 nurses from 10 university hospitals in Turkey. Hierarchical multiple regression analysis was conducted to test the proposed model.

The findings of this study support the negative effect of emotional labor on workplace violence and the mediating effect of patient-positive treatment. Moreover, when organizational support is low, the relationship between emotional labor and workplace violence is strong. In contrast, the effect is weak when organizational support is high.

The findings of this study suggest that health-care administrators should offer more training to nurses to help them manage their emotions while interacting with their patients. This leads to positive interpersonal relationships, which, in turn, lowers workplace violence. Moreover, health-care administrators should pay more attention to the buffering role of perceived organizational support for those subordinates with low emotional labor and higher workplace violence.

The study provides new insights into emotional labor’s influence on workplace violence and the moderating role of organizational support in the link between emotional labor and workplace violence. The paper also offers practical assistance to nurses in the health-care industry interested in building positive patient treatment and trust with their patients and minimizing workplace violence.

The purpose of this paper is to undertake a systematic literature review to appraise the current evidence relating to the factors associated with violence and aggression in adult psychiatric hospital inpatient settings.

A systematic search of following four databases was conducted: Scopus, PsychINFO Medline, CIHAHL and PsychArticle. Following the application of the inclusion criteria, ten papers were extracted and included in the review. A quality appraisal tool, Mixed Methods Appraisal Tool (MMAT) version 2011 (Pluye et al., 2011), was employed for the appraisal of the qualitative and quantitative studies. MMAT has been designed for systematic literature reviews that include qualitative, quantitative and mixed methods studies. Of these, eight were of quantitative methodology and two were of qualitative studies.

These ten papers provide an insight into factors associated with violence and aggression towards nursing staff. Three main themes were identified: the environment, attitudes/interaction of staff, and the patient’s mental illness. The themes were important factors in the causes of violence but were interlinked highlighting the complex nature of violence towards nursing staff. The findings support the need for training for nursing staff and the development of ongoing support and for organisations to consider both the environment and the restrictive procedures to help reduce violence and aggression towards nursing staff.

The paper concludes by outlining the importance of considering the three main themes for clinical practice, training and development of secure services.

This paper gives insight into the factors associated with patient violence and aggression towards nursing staff in a secure setting.

Workplace violence against medical staff has become an endemic problem in the healthcare sector in Jordan. This study investigates the perceived main causes of workplace violence (medical staff, administrative, patients, patient's escorts and legislative) against physicians and nurses in public hospitals.

A self-administered questionnaire was used to collect data from a convenient random sample of 334 physicians and nurses employed in Jordanian public hospitals. Descriptive statistics and analysis of variance were used to answer questions and test hypotheses.

Findings indicated that the practice of the causes of workplace violence behaviors assessed by the participants is at a moderate level in Jordanian public hospitals with a mean value of 3.26. The causes of violence were reported as most causative to least causative: patient escort (M = 3.60), legislative (M = 3.56), patients (M = 3.40), administrative (M = 3.16) and medical staff related (M = 2.74), respectively. Analysis showed statistical differences in the participants' attitudes toward the causes of workplace violence behaviors due to their gender, job title, education level, experience and income.

This study has a significant practical contribution in providing information about the causes of workplace violence that will help health policymakers and hospital administrators to deter violence against medical staff. To reduce or eliminate the potential causes of violence, several actions can be taken, such as criminalizing violent behaviors, managing work pressure, staff shortages, developing comfortable and secure medical treatment settings, training the medical staff on aggression and stress management, and enhancing their communication skills with patients and their escorts. Findings also highlight the need for hospital management to develop protocols for reporting and dealing with workplace violence.

This is one of the first studies in the Arab context that examines the causes of workplace violence against medical staff.

This paper seeks to explore the perceptions of both staff and patients to the involvement of the Criminal Justice System (CJS) as a response to physical assaults committed by patients. Even though the ‘zero tolerance’ policy advocates the prosecution of perpetrators of violence, problems can arise when attempting to take legal action against psychiatric patients as the displaying of violent behaviour can be due to their mental illness. Nevertheless, the impact of an assault on victims, including both patient and staff members, can be detrimental. To the best of the author's knowledge these issues have not been investigated in a women's enhanced medium secure service (WEMSS). The conclusions drawn from this research are that the majority of respondents perceived the involvement of the CJS as crucial to maintaining high levels of morale among patients and practitioners, as well as assisting in deterring patients from committing subsequent assaults. However, police reports illustrated reluctance on the part of the Police and the Crown Prosecution Service (CPS) to prosecute inpatients.

The purpose of this paper is to examine the consequences of workplace violence against healthcare staff in Jordanian public hospitals.

A convenient sample included 334 physicians and nurses employed in eight different public hospitals, different departments and different working shifts were surveyed by filling the designed questionnaire.

The findings indicated workplace violence had a clear moderate impact on the respondents’ interaction with patients, performing work responsibilities, ability of making decisions, and professional career. The most frequent workplace violence consequences were damaging staff’s personality and prestige, increasing laziness and unwillingness to serve patients. Workplace violence consequences also included aggressive behavior, fear while dealing with patients, increase job insecurity, and lack of professional responsibility. In addition, demographic variables such as gender, education, job title, working shift, and income showed statistical significant differences in the attitudes of participants toward the consequences of workplace violence.

This study highlighted the necessity of healthcare policy makers and hospital administrators to establish violence free and safe working environments in order to retain qualified healthcare staff that in turn improves the health services quality.

There is a lack of research and documentation on violence in the healthcare settings in developing countries. This study is one of the first to examine the consequences of workplace violence that affect public physicians and nurses.

This study examined the ability of the HCR‐20 Scale (version 2) to predict incidents of in‐patient violence during a stay on a medium secure ward. The study was carried out retrospectively on a sample of 94 admissions, using reports pre‐existing at the time of admission and nursing observations of behaviour in the two weeks that followed admission. The sample group was made up of mentally disordered offenders and patients with challenging behaviour. Their episodes of care averaged two years.The H and C scores, singly or combined, did not show powerful predictive capacity for the sample as a whole, which had a high base rate for violence. Insufficient variance and poor inter‐rater reliability precluded use of the R variable. For purposes of analysis, violent patients were also grouped on the number of incidents committed during their episode of care. Here the C Scale items showed strong predictive capacity for patients with more than 10 incidents during their stay. The paper argues that the latter finding supports a method of predicting admissions at risk of frequent incidents of violence.

Substance misuse (SMU) is widely prevalent in mentally disordered offenders and is linked with violence and offending behaviour. There is however, a scarcity of literature dedicated to investigating SMU and its clinical correlates in relation to patients detained within high secure hospital settings. The purpose of this paper is to investigate the extent and severity of SMU and corresponding treatment needs in patients with a primary diagnosis of personality disorder (PD) in comparison with mental illness (MI) in a high secure hospital.

The responsible clinicians of all patients (n=240) detained in a high secure hospital were asked to record information using a SMU screening questionnaire over a ten-month period. Details requested included substance type, history of past use and assessment and treatment needs. Data were recorded and then analysed: descriptive statistics were conducted to report historical use of substances, cross tabulations and χ² analysis explored the relationship between SMU and treatment status and diagnosis and offending behaviour and a means comparison analysis was employed to explore length of stay and treatment of SMU.

A total of 230 questionnaires were returned (95 per cent of the patient population). A history of SMU was reported in 88.6 per cent of the sample, with alcohol and cannabis misuse being the most prevalent. At least one substance had been abused by 74.3 per cent of the sample. In two-thirds of the sample, SMU was linked with the onset of mental health problems and symptom exacerbation, including violence. Interestingly, patients with a diagnosis of MI as compared with PD were more likely to have used substances (93.3 per cent compared to 81.9 per cent) and were more likely to need treatment for SMU (64.3 per cent compared to 36.8 per cent). In those with an MI diagnosis, SMU was more likely to be linked with violence and index offence (74.3 per cent compared to 59.0 per cent).

SMU is significantly prevalent in high risk mentally disordered offenders and linked to onset of mental health problems and offending. Patients with schizophrenia have a higher prevalence of SMU than PD and are likely to be more in need of treatment. Violence and offending are more likely to be related to SMU in schizophrenia than in PD.

This study substantiates existing evidence that SMU contributes to mental health problems and criminogenic behaviour. Furthermore, the study reports new findings that characterize differences of the relationship of SMU to offending in schizophrenia and PD in forensic psychiatric patients presenting to a high secure hospital.

Official criminal justice statistics (e.g. arrest rates) underestimate the frequency of crime because not all crime gets reported to authorities, a phenomenon known as the “dark figure of crime.” The present study aims to examine the dark figure of violence committed by discharged psychiatric patients.

Multiple reporting modalities permitted a direct comparison between patients whose violence was officially detected to those whose violence was self-reported but not officially detected, along with differences in the nature of violent acts.

Only 5% of violent individuals were officially detected, 26% of violent individuals were both officially detected and self-reported their violent behavior, while 68% of violent individuals self-reported their violent behavior and were not officially detected. The type of violent acts did not vary as a function of whether they were officially detected or self-reported. However, differences were observed for the location of violence, the relationship to the victim and whether an injury resulted. Older individuals, those with prior arrests and those with higher psychopathy scores are some of the factors associated with an increased likelihood of officially detected violence.

The data were collected from three sites in the USA. Generalizing the specific findings to other locations and countries ought to be done cautiously.

Studies ought to include multiple methods to measure violence. Self-report seems to be especially important to the extent one is concerned with measuring actual violence rather than violence that gets detected by legal authorities.

This study highlights an important limitation of relying exclusively on official criminal justice statistics when studying violence or recidivism in the community.

Workplace violence is a serious problem within the National Health Service (NHS). To combat this and to reduce the incidence of abuse and aggression shown to staff, a zero tolerance public campaign was introduced in 2007 within the UK. The campaign endorsed employer‐led zero tolerance policies, despite any evidence of the effectiveness of this approach and concerns that it is discriminatory and denies health care to those who most need it. Decisions to exclude patients from GP registers are subject to varied interpretations regarding what is deviant behaviour and the blacklisting of patients is unregulated and subject to ambiguity. Furthermore, staff training programmes, which emphasise de‐escalation strategies, have not proven to be effective and can even increase violent incidences. Initiatives to provide safe havens for those excluded, while initially believed to be effective, raise many ethical arguments about the ‘ghettoising’ of health care for those already socially excluded. Research is needed into these centres in the hope of providing some of the answers, particularly around the triggers of violence, how violence is perceived and how it can be prevented.