Coping strategies for nurses when caring for mental health care users with violent and aggressive behaviour in mental health care institutions in North West province

Abstract

Introduction: Violent and aggressive behaviour of mental health care users continues to be a serious global nursing problem. When nurses are confronted with violence and aggression in mental health care institutions, it affects them and their ability to perform as a team, as well as to perform their daily tasks and duties. The study aimed to explore and describe the coping strategies of nurses when caring for MHCUs displaying violent and aggressive behaviour in mental health care institutions in North West province. Methods and design: A qualitative-exploratory-descriptive and contextual research design was used. Th1e study population included 11 nurses who were caring for, treating and rehabilitating mental health care users with violent and aggressive behaviour in two mental health care institutions in North West province. A non-probability purposive sampling technique was used to select the nurses who met the inclusion criteria for participation from the study population. Face-to-face semi-structured individual interviews supplemented with field notes were used to collect data. A digital audio-recorder was used to record the interviews. Six steps of thematic analysis were used, namely: becoming familiar with the data, generating the initial codes, searching for themes and sub-themes, reviewing the themes, defining the themes, and writing up. Findings: Four themes emerged from the face-to-face semi-structured individual interviews and field notes, namely: factors contributing to violence and aggression, negative experiences in caring for mental health care users displaying violent and aggressive behaviour, coping strategies used by nurses and suggestions to enhance effective coping with violent and aggressive behaviour. Effective coping strategies mentioned by nurses include problem-focused coping strategies, appraisal-focused coping strategies and social-focused coping strategies. Conclusion: The findings of this study may benefit nurse practitioners, researchers and educators. Recommendations were made for the training of nurses and for nursing management to support nurses to cope more effectively with violence and aggression.