L’efficacia di utilizzo delle tecniche di de-escalation nel paziente psichiatrico: revisione narrativa

Introduction: Aggression and violence in the workplace represent an ever-increasing psychosocial phenomenon and this can cause possible important repercussions for the entire treatment process. Objective: to evaluate the effectiveness of using de-escalation techniques in the management the psychiatric patient’s aggressive actions. Methods: To conduct the following review, a research question was outlined using the PIO methodology. Subsequently, a narrative review of the literature was conducted, through the use of the PubMed and EMBASE databases. Results: From the review of the international literature, only three studies met our inclusion criteria Selected studies show that mental health workers react differently to violence. Some relate to patients by generating positive solutions, while others manage patients with coercive measures. The effectiveness of the use of de-escalation techniques in the management of aggressive actions and that both staff and patients aspire to achieve non-confrontational and social relationships while interacting in violent and threatening situations can be seen. Conclusions: De-escalation is the most effective technique only after careful knowledge of the patient, his pathologies and any prodromal signs and symptoms that may indicate the onset of aggressive behavior. Furthermore, it is more complicated with subjects having a previous history of aggression. However, the absence of adequate staff training emerges, which can guarantee the correct implementation of the intervention and which can make nurses safer in the management of aggressive action and of the violent patient.