Agitation and Aggression in Psychiatric Care: Insights From Nursing Observations in a Turkish Mental Health State Hospital

Introduction Nursing observations are a critical component of psychiatric services, playing a key role in ensuring patient safety and maintaining high standards of care. Aims This study aims to examine the relationship between nursing observations and their impact on patient agitation and aggression in a psychiatric state hospital. Methods The study included 363 inpatients and was part of a broader investigation into the impact of nursing services on treatment processes during hospitalisation in a psychiatric hospital. The data were collected through observation forms completed by nurses and analysed statistically. Results Certain nursing interventions and observations were significantly associated with patient agitation and aggression. Weak to moderate correlations were found between various behaviours and restraint–isolation, excitation and agitation. Linear regression models revealed significant predictors for restraint, excitation and agitation based on observed behaviours. Discussion There remains uncertainty regarding which observation areas should be prioritised and how they should be evaluated. A structured, evidence‐based psychiatric nursing observation guideline is urgently needed to address inconsistencies in care. Limitations Due to the lack of standardised assessment tools in this area, conclusions were based on electronically documented qualitative observations. Implications The findings suggest that targeted nursing interventions can effectively reduce agitation and aggression, thereby improving patient safety and care quality. Recommendations Enhancing the structure and quality of nursing observations could lead to significantly better outcomes for individuals with psychiatric disorders.