Situational/interactional model
A number of studies support the view that negative staff and
patient relationships lead to patient aggression (Nijman et al.
1999, Duxbury 2002). Sheriden et al. (1990) found that
patients commonly saw conflicts with staff as contributory.
Whittington and Wykes (1994a) suggested that certain staff
are prone to being assaulted, indicating problematic rather
than therapeutic relationships (Harris & Morrison 1995).
Limit-setting styles, coupled with a lack of opportunity for
negotiation, are also reported to be problematic (Lancee et al.
1995), and some nurses have been accused of ‘going in
strong’ (Whittington & Wykes 1994b). Professionals, it
seems, are increasingly forced to act in controlling ways
because of institutional pressures, despite controversy about
the efficacy of these approaches (Gudjonsson et al. 2004).
It is therefore important to develop models to examine the
complex interplay of variables and address their impact when
managing aggression in healthcare. Subsequently, greater
research into strategies that promote the use of therapeutic
communication should be encouraged (Nijman 2002).