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Violent behaviour in a forensic psychiatric hospital in Finland: an analysis of violence incident reports

Authors

  • S. Kuivalainen RN MSc PhD Student,

    Nursing Director, Corresponding author
    1. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio
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  • K. Vehviläinen-Julkunen RN RM PhD,

    Professor
    1. Department of Nursing Science, University of Eastern Finland, Kuopio
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  • A. Putkonen MD PhD,

    Specialist in Psychiatry and Forensic Psychiatry
    1. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio
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  • O. Louheranta ThM PhD,

    Supervisor
    1. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio
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  • J. Tiihonen MD PhD

    Professor and Chairman, Research Professor, Professor
    1. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio
    2. National Institute for Health and Welfare, Helsinki, Finland
    3. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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  • Competing interest statement: None.
  • Ethical approval: The research ethical committee of the local hospital district gave approval on June 10th, 2010.
  • Funding of the study: No external funding. Study was supported by funding from the Annual EVO Financing (special government subsidies from the Ministry of Health and Welfare, Finland).

Abstract

Accessible summary

  • Over half of the violent incidents considered in this study were unexplained.
  • The risk for violent behaviour inside the hospital was the highest for civil patients. The risk rate in this group was 12 compared to criminal patients' risk rate of one.

Abstract

The aim of this paper was to explore the frequency and provocation of physically violent incidents in a Finnish forensic psychiatric hospital. Three years (2007–2009) of violent incident reports were analysed retrospectively. The data were analysed by content analysis, and statistically by Poisson regression analysis. During the study period a total of 840 incidents of physical violence occurred. Six main categories were found to describe the provocation of violence where three of these categories seemed to be without a specified reason (61%), and three represented a reaction to something (36%). The risk for violent behaviour was highest for the civil patients (RR = 11.96; CI 95% 9.43–15.18; P < 0.001), compared to criminal patients (RR = 1). The civil patients represented 36.7% of the patients, and in 43.6% of the studied patient days, they caused 89.8% of the reported violence incidents. Patients undergoing a forensic mental examination did not frequently behave aggressively (RR = 1.97; CI 95% 0.91–4.28). These results can be used in the reorganization of health-care practices and the allocation of resources.

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