Accessible summary: In the previous paper we described a model explaining differences in rates of conflict and containment between wards, grouping causal factors into six domains: the staff team, the physical environment, outside hospital, the patient community, patient characteristics and the regulatory framework. This paper reviews and evaluates the evidence for the model from previously published research. The model is supported, but the evidence is not very strong. More research using more rigorous methods is required in order to confirm or improve this model. In a previous paper, we described a proposed model explaining differences in rates of conflict (aggression, absconding, self‐harm, etc.) and containment (seclusion, special observation, manual restraint, etc.). The Safewards Model identified six originating domains as sources of conflict and containment: the patient community, patient characteristics, the regulatory framework, the staff team, the physical environment, and outside hospital. In this paper, we assemble the evidence underpinning the inclusion of these six domains, drawing upon a wide ranging review of the literature across all conflict and containment items; our own programme of research; and reasoned thinking. There is good evidence that the six domains are important in conflict and containment generation. Specific claims about single items within those domains are more difficult to support with convincing evidence, although the weight of evidence does vary between items and between different types of conflict behaviour or containment method. The Safewards Model is supported by the evidence, but that evidence is not particularly strong. There is a dearth of rigorous outcome studies and trials in this area, and an excess of descriptive studies. The model allows the generation of a number of different interventions in order to reduce rates of conflict and containment, and properly conducted trials are now needed to test its validity.

Background: Psychiatric Intensive Care Units (PICU) have been part of most inpatient psychiatric services for some time, although information about their functioning and outcome has not previously been collated. Aim: To conduct a systematic literature review to assess the current state of knowledge about such services. Method: A search of electronic databases was undertaken, followed by obtaining additional references from items obtained. Results: Over 50 papers in English containing some empirical data were identified. Most studies were retrospective. Typical PICU patients are male, younger, single, unemployed, suffering from schizophrenia or mania, from a Black Caribbean or African background, legally detained, with a forensic history. The most common reason for admission is for aggression management, and most patients stay a week or less. Evidence of the efficacy of PICU care is very poor. Conclusions: Most research so far has been small scale, and more substantial work using better methodologies is clearly required.

Amaç: Bu çalışma Türkiye'de sağlık çalışanlarına yönelik şiddetle ilgili Ocak 1999-Temmuz 2010 tarihleri arasında yayınlanmış çalışmaların gözden geçirilmesi ve çalışmalardan elde edilen verilerin sistematik biçimde incelenmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Konuyla ilgili 41 ulusal ve uluslararası yayına ulaşılmış olup araştırmaya dahil edilme kriterlerine uygun olarak 29 yayın çalışma kapsamında değerlendirilmiştir. Tüm yayınlar çalışma yöntemleri ve bulguları açısından sistematize edilerek incelenmiştir. Bulgular: Bu sistematik inceleme sonunda sağlık çalışanlarına yönelik her türlü şiddet türünün yüksek olduğu, şiddetin en fazla hasta yakınları tarafından gerçekleştirildiği, bunu hastaların izlediği sonucu bulunmuştur. Genel olarak sözel şiddete uğramada kadınların, fiziksel şiddete uğramada erkeklerin, hem sözel hem de fiziksel şiddete uğramada yine kadınların ve meslek olarak da hemşirelerin daha riskli gruplar olduğu, saldırganların daha çok erkek ve ruhsal sorunları olan veya alkol bağımlısı, madde kullanıcısı kişilerden oluştuğu, saldırı nedeninin çoğunlukla organizasyonel sorunlardan kaynaklandığı, fiziksel şiddet bildirim oranının diğer saldırılara göre daha yüksek olduğu, saldırı sonrası mağdurlarda en çok emosyonel ve fizyolojik belirtiler görüldüğü ve genel olarak yetersiz baş etme düzeneklerinin kullanıldığı belirlenmiştir. Sonuç: Dünyada olduğu gibi, Türkiye'de de sağlık çalışanlarına karşı şiddet önemli bir sorundur. Konuyla ilgili çalışmaların sistematize edilmesi ile sorunun önemi ve boyutları konusunda bilimsel kanıtlara ulaşılmıştır. Bu kanıtların hem gelecekte yapılacak çalışmaların kapsamlarını belirlemede, hem de klinik alanda sorunun çözümü için gerekli önlemlerin hazırlanmasında işlev göreceği düşünülmektedir.

Empathy is one of the fundamental concepts in nursing, and it is an ability that can be learned. Various education models have been tested for improving empathic skills. Research has focused on using oral presentations, videos, modeling, practiced negotiation based on experiences, and psychodrama methods, such as role playing, as ways to improve empathy in participants. This study looked at the use of expressive arts to improve empathic skills of nursing students. The study was conducted with 48 students who were separated into five different groups. All groups lasted for two hours, and met for 12 weeks. Expressive art and psychodrama methods were used in the group studies. The Scale of Empathic Skill was administered to participants before and after the group studies. Before the group study took place, the average score for empathic skill was 127.97 (SD = 21.26). After the group study, it increased to 138.87 (SD = 20.40). The average score for empathic skill increased after the group (t = 3.996, p = .000). Results show that expressive methods are easier, more effective, and enjoyable processes in nursing training.