Deeskaleringsprocesser: En gennemgang af litteraturen om deeskalering af vold og trusler på psykiatriske afdelinger

Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. Insufficient knowledge and skills about interacting with patients in a non-confrontational manner can initiate a vicious cycle, where restrictive interventions, such as limit setting, provoke further violence. De-escalation is recommended as an intervention that can avoid violence through psychosocial and verbal interventions. However, there is limited knowledge about what de-escalation and de-escalation processes are.

An integrative review using Whittemore and Knafl’s framework was undertaken to explore how the research literature defined and described de-escalation processes. De-escalation was described as experience based knowledge that could be organised under four themes: 1) Definitions and understanding, 2) Actions and strategies, 3) Competences and skills, and 4) Education and learning. These themes highlighted an emerging common understanding of de-escalation as a graduated solution of potential violence where staff members express empathy and solidarity with the patient. However, knowledge about how staff members learn de-escalation remains limited and more research is needed in order to develop efficient learning programs.