Technical Institute of Nursing Assiut University

Management Of Patient With Aggressive

Behavior

Group ( )
Under supervision of

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Outlines
[Link]
[Link] Of Aggression
[Link] Of Aggression
[Link]
[Link] Management
-Assessment
-Nursing Diagnosis
- Nursing Outcome
-Intervention
6-Seclusion Room
7- Management Of Aggression Behaviour
8-Reference
9- Students Name

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Introduction
Violent and aggressive behavior (AB) is a major public health
problem; it develops as a result of complex interactions between
neurobiological, cultural and environmental factors. It is
heterogeneous in its manifestations and origins. Aggression is
defined as any threatening or physically assaultive behavior
directed at person or the environment.1 Violence refers to actions
that inflict physical harm in violation of social norms. Organic brain
diseases may contribute towards criminal and AB if they are
associated with symptoms such as impaired judgment, irritability
and sudden anger, mistrustfulness and paranoid ideation. AB
manifests in patients with dementia, causes serious burden on
caregivers and often co-exists with other types of disturbed
behavior or psychiatric symptoms.
feeling of anger or antipathy resulting in hostile or violent
behavior, readiness to attack or confront "
The aggressive patient usually presents as a danger to others, to
property and sometimes to himself
Aggression could occur in the A/E, OPD either psychiatry or
others, the hospital ground or the wards, therefore the policy
applies to all these situations accordingly.
Aggressive behavior doesn’t just violate social boundaries. It can
also affect relationships and even have professional or legal
consequences. Recognizing the ways aggression shows up in
your life can help you take steps toward addressing it, along with
anger and any other emotions that might play a part.

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Definition Of Aggression:
Aggression is defined as a behavior that is intended to
cause harm, injury, or pain to another person or oneself. It
can be verbal, physical, or both. Aggressive behavior is a
common occurrence in healthcare settings, and it can be
challenging to manage.

Types Of Aggression:
The 4 Types Of Aggression
Most people automatically associate the term “aggression”
with actions that cause physical injury, whether to the
aggressor or to others.
While that does cover some aggressive behavior, it falls
short of providing a comprehensive definition and
effectively labels the rest as nonaggressive.
That’s why there’s just a catch-all word for the various
forms of aggression we see every day: “aggression.”
Physical, mental, emotional, and verbal aggression are
initially identified when defining the term “aggression.”
Let’s take a closer look at each one:

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Physical Aggression – Aggression that results in
actual physical harm, such as punching, biting, or
brandishing a weapon.
Mental Aggression – Aggression that is intended to
cause mental injury, such as heightened emotional
arousal or a state of despair.
Or ridiculing, verbal threats, isolating one s partner from
family and friends, and attempting to control one s partner

the result of the extreme negative emotions we're

experiencing at the time that we aggress and is not really
intended to create any positive outcomes
Emotional Aggression – Abusive behavior that
produces mental distress and a difficulty in expressing
oneself.
Verbal Aggression – Harassment is when one person
uses their words to make another feel less secure in their
own skin.

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Physical Aggression

Aggression

Emotional Aggression
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Causes of Aggression:
Aggression can be caused by various factors such
as:
1. Mental illness - patients with mental illness may
experience aggression as a symptom of their
condition. Mental illness can affect a patient's
ability to regulate their emotions and respond
appropriately to stressors.

Mental illness

2. Physical discomfort - patients who are in pain

or discomfort may become agitated and aggressive.
It is important for nurses to assess and manage the
patient's physical discomfort to reduce their risk of

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aggressive behavior.
Physical discomfort
3. Substance abuse - patients who abuse drugs or
alcohol may become agitated and aggressive.
Substance abuse can affect a patient's judgment
and increase their risk of violence.

Substance abuse
4. Hormonal imbalance
A hormonal imbalance in an individual can certainly
contribute to aggressive behavior. For example,
high levels of testosterone contribute to high levels
of aggression. This explains why males are
characteristically more aggressive than females.
5. Genetics
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Aggression can also be passed down genetically.
Children are at a greater risk of adapting aggressive
tendencies if they have a biological background for
it. Time and time again, father and son both display
aggressive behavior.

6. Physiological illness and temperament

Serious illness can have a major effect on an
individual’s mood and behavior, as the stress and
other mental effects may bring about greater
aggression. Additionally, one’s temperament can
play a role in aggression. People with bad tempers
typically become aggressive more quickly than
calmer individuals.
7. Social learning (Learned behavior)
Aggression can be learned. Some become more
aggressive due to personal experiences or
observational learning. For example, children are
always looking for cues on how to act, as illustrated
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by the Bobo doll experiment. They learn to act
aggressively when they watch someone else
commit violent acts like in movies or video games.

8. Psychological frustrations
It’s human nature to become frustrated when life
just doesn’t seem to be going so well. This
frustration may involve work or love, for example,
and can lead to an all-around feeling of negativity.
This negativity then represents a threat, which can
lead to aggression.

9. Past traumatic experiences - patients who

have experienced trauma in the past may be more
likely to become agitated and aggressive. It is
important for nurses to assess their patient's history
of trauma and provide appropriate support.

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10-Neurophysiological Disorders.
11- Television violence: A link between aggression and
televised violence has been noted. The more televised violence
children watch, the greater is their level of aggression against
others. Mechanisms underlying the effects of televised and filmed
violence on the behavior of the viewers

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Nursing Management:
Nurses play a critical role in managing patients with
aggressive behavior. The nursing management of
patients with aggressive behavior involves the
following:

1. Nursing Assessment - The nurse should carry

out a comprehensive assessment of the patient to
1-identify the cause of the aggression
2- the triggers
3- assess the type and the severity of aggression
4- the patient's risk of harm to self or others.
The nursing assessment should include a review of
the patient's medical history, a physical
examination, and an evaluation of their mental
state.

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2. Nursing Diagnosis
1. the patient risk for violence related to
aggression to other people or animals
2. Impaired social interaction related to hostility
towards those in authority.
3. Chronic low self esteem related to lack of value
to self.
4. ineffective coping and responses to
psychopathology (e.g. delusions,
hallucinations)
5. Risk for deficient fluid volume related to
anorexia
6. Risk for social isolation related to withdrawal
behaviour

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3. Nursing Outcome

1. The client will not hurt others or damage

property.
2. The client will participate in treatment.
3. The client will effective problem solving and
coping skills.
4. The client will use age-appropriate and
acceptable behaviors when interacting with
others.
5. The client will verbalize positive, age-
appropriate statements about self

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Nursing Intervention
1. Decreasing violence and increasing
compliance with treatment
2. Improving coping skills and self-esteem
3. Promoting social interaction
4. Providing client and family interaction
5. Frequency of review (e.g. every 15 minutes)
is specified and each review should be
documented.
6. If seclusion and restraint needs to be
extended, the whole procedure of
authorization and nature of seclusion and
restraint should be documented.

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7. Seclusion Room
- In cases where the patient poses an immediate
risk of harm to self or others, the nurse may
consider transferring the patient to a seclusion
room. However, seclusion should only be used as a
last resort and in compliance with institutional
policies and legal requirements.

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 Seclusion Room
Reference
1. [Link]
713611115
2. [Link]
1/j.1447-0594.2011.00730.x
3. [Link]
gement+Of+Patient+With+Aggressive+Behavior
&hl=ar&as_sdt=0&as_vis=1&oi=scholart
4. [Link]
[Link]

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‫‪Students Name‬‬

‫عمرو امين دمحم‬

‫عمرو دمحم‬
‫دمحم حسني دمحم مجاهد‬
‫دمحم عبد هللا دمحم كامل‬
‫دمحم عاطف‬
‫دمحم علي عرفه‬
‫مصطفى تركي‬
‫معاذ علي حسن‬
‫مينا سليمان‬
‫نادر عبدالكريم‬
‫هشام خالد‬
‫هناء خلف‬

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