Patient Violence towards Mental Health Nurses: A Concept Analysis

Table 5

Results of the final analytic phase.

Category	Items	Indicators
Types of violence	Emotional violence	Bullying (e.g., accusing a nurse unfairly, demanding apologies repeatedly, spreading rumours, constantly reminding of patients’ presence, or questioning nurses’ decisions)
	Physical violence	Physical assaults
		Physical threats
	Sexual harassment	Sexual abuse (physical or verbal)
	Verbal violence	Verbal abuse
		Verbal threats
Antecedents	Predictable factors	Internal factors
		External factors
		Situational factors
	Unpredictable factors	Occurred suddenly (unexpected)
		Unprovoked
Consequences	Physical injuries	Death
		Physical injuries (from mild to severe)
	Psychological response	Burnout
		Emotional distress
		Loss of confidence and self-esteem
		Maintaining physical/psychological safe distances from violent patients
		Psychological trauma
		Sceptical attitude to their jobs
	Seeking support	Seeking support from their institution
		Seeking emotional support from colleagues
Attributes	Common and frequent	Common phenomenon
		Frequently occurred
	Multifactorial	Caused by predictable (internal/external/situational) or unpredictable factors
		Intentional or not
	Unreported	Did not consider incidents as important
		Fear of blaming
		Feeling negative emotions
	Vulnerability of nurses to violence	A culture that accepts the violence
		Blaming the victims
		One-sidedness
		Responsibility to their patients and profession
		Self-criticism