Patient violence towards nursing staff in closed psychiatric wards: it's long-term effects on staff's mental state and behaviour.

The purpose of this study was to (a) investigate in the Israeli context how patient violence towards staff (nurses and auxiliaries) affects their mental state and professional performance; and (b) to investigate how the variable, internal/external locus of control, mediates the effects of this violence. Four of the five hypotheses were confirmed: type, severity and frequency of attack was correlated with the level of staffers' psychological distress and change in professional functioning; psychological distress was correlated with a negative change in professional functioning and was higher in attacked staff than in those not attacked; internal locus of control was correlated with lower psychological distress and less negative professional functioning, whereas an external locus of control correlated with higher distress and more negative functioning. A sharper awareness of the effects of violence on staff is vital at all levels of management. Most attention is given to physical injury but verbal aggression and threats, often disregarded, may have the strongest negative influence. Emotional/psychological injury was rarely treated and needs to be.