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Keywords:

  • inpatient;
  • management;
  • prevention;
  • staff training;
  • violence;
  • ward climate

Accessible summary

  • • 
    Violence prevention and management is an important part of inpatient psychiatric nursing because both patients and staff need to feel safe and secure.
  • • 
    The Bergen model is a violence prevention and management staff-training programme that is based on the three essential staff factors of the City model: positive appreciation of patients, emotional regulation and effective structure.
  • • 
    Based on the City model, we developed a 13-item questionnaire in order to find out how patients and staff rated the violence prevention and management climate on psychiatric wards where the staff was trained according to the Bergen model compared with wards where the staff was not trained.
  • • 
    The result showed that the staff on trained wards had a more positive perception of the violence prevention and management climate on four of the items and the patients on one item.

Abstract

Violence prevention and management is an important part of inpatient psychiatric nursing and specific staff training is regarded essential. The training should be based on primary, secondary and tertiary prevention. In Stockholm, Sweden, the Bergen model is a staff-training programme that combines this preventive approach with the theoretical nursing framework of the City model that includes three staff factors: positive appreciation of patients, emotional regulation and effective structure. We evaluated this combination of the Bergen and City models on the violence prevention and management climate in psychiatric inpatient wards. A 13-item questionnaire was developed and distributed to patients and staff in 41 wards before the staff was trained and subsequently to 19 of these wards after training. Data analyses included factor analysis, Fisher's exact test and Mann–Whitney U-test. The result showed that the staff on trained wards had a more positive perception of four of the items and the patients of one item. These items reflected causes of patient aggression, ward rules, the staff's emotional regulation and early interventions. The findings suggest that a focus on three levels of prevention within a theoretical nursing framework may promote a more positive violence prevention and management climate on wards.