Model of therapeutic and non-therapeutic responses to patient aggression.

The primary purpose of this qualitative meta-synthesis was to explicate a framework of therapeutic nursing management of patient aggression in psychiatric settings. Findings from 15 qualitative research reports were placed into an electronic matrix, analyzed, and interpreted using content analysis, memoing, and diagramming. Nurses therapeutically respond to patient aggression using one of two response styles, intuitive or emergent. Authentic engagement characterizes both of these styles and involves grounding the opportunity for interaction in the context at hand, reciprocity between the nurse and patient, limit setting, and teamwork. Conversely, two non-therapeutic response styles (inflexibility and disengagement) lead to non-therapeutic outcomes.