THE PROCESS OF ESCALATING BEHAVIOR IN PSYCHIATRIC PATIENTS.
Contributors: Catholic University of America.
Published: 1994
Number of pages: 145
Subjects: Health Sciences, Nursing.; Health Sciences, Mental Health.
Description: Helping patients identify and manage highly disruptive and dangerously dysfunctional behavior is a major role of psychiatric nurses. In this study, such behavior was described as escalating behavior and was theoretically defined as behavior characterized by marked elevation in the individual's physical and psychological state, representing a change from his previous state of being, and of an intensity that threatened his ability to control the behavior. The purpose of the study was to describe the process of escalating behavior from the perspective of the psychiatric patient.

An exploratory field study design based on grounded theory methodology was used. The sample consisted of 20 informants, patients in inpatient psychiatric units. Data were collected by open-ended interview.

The substantive theory generated accounted for the process of escalating behavior and was described through four phases. During the Balancing phase the informants used familiar strategies to manage actively the challenges they were experiencing. During Tipping the Scales, the informants became aware of changes in thoughts, feelings, and behaviors that were beyond their ability to manage. While Being Overpowered, the informants felt overtaken by powers beyond their control and no longer in charge of managing what was happening to them. While Reflecting, the informants reviewed their experience of escalating behavior, named the problems they encountered, identified more helpful interventions, and considered the consequences of the behavioral episode. The core variable, Perceived Environmental Failure, was described as the informants' perception that the resources needed to manage the experience were not available in the environment.

Based on the qualitative findings, the following conclusions were drawn: The phases of escalating behavior were influenced by intrapersonal and environmental factors. The informants perceived that they did not have the resources in the environment that they needed to manage the overwhelming challenges. The informants had difficulties with the development and maintenance of trusting relationships with staff and with trust in the safety, therapeutic value, and predictability of the environment. The informants identified out of control behavior as a later stage of a sequence of events that could have been interrupted and managed more effectively at earlier stages.
Notes: Source: Dissertation Abstracts International, Volume: 55-02, Section: B, page: 0368.

Thesis (D.N.SC.)--THE CATHOLIC UNIVERSITY OF AMERICA, 1994.

School code: 0043.