Objective. We explored perspectives of emergency department users (patients and visitors) regarding the management of acute behavioural disturbances in the emergency department and whether these disturbances influenced their levels of anxiety. Methods. Emergency department patients and visitors were surveyed using the State-Trait Anxiety Inventory, and a purpose-designed questionnaire and semistructured interview. The main outcome measures were themes that emerged from the questionnaires, the interviews, and scores from the state component of the State-Trait Anxiety Inventory. Results. 70 participants were recruited. Users of the emergency department preferred behaviourally disturbed people be managed in a separate area from the general emergency department population so that the disturbance was inaudible ( ) and out of view ( ). The state anxiety levels of those that witnessed an acute behavioural disturbance were within the normal range and did not differ to that of ED patients that were not present during such a disturbance (median, control = 37, Code Grey = 33). Conclusions. Behavioural disturbances in the emergency department do not provoke anxiety in other users. However, there is a preference that such disturbances be managed out of visual and audible range. Innovative design features may be required to achieve this. 1. Introduction Violence in the health sector and in particular, emergency departments (EDs) is well documented and spans decades [1–3]. The Australasian College for Emergency Medicine states that “acts of violence” include “verbal abuse, threats, and aggressive behaviours, in addition to acts of physical-contact violence” [4]. Violence in the emergency department is arguably an inevitable consequence of an ED case mix-those with conditions that are life-threatening, produce unbearable pain or altered mental states are at risk of agitation which can escalate to violence. Patients are the main users of healthcare systems. However, previous studies conducted in the emergency department have focused on staff perspectives [5–7] and the profiles of perpetrators of violence and aggression [5, 7–11]. To our knowledge no research has examined the perspectives of users present in the emergency department during violent or potentially violent incidents. Eliciting users’ opinions can contribute to the quality of healthcare and highlight possible flaws or strategies that are not apparent to healthcare professionals or administrators. Additionally, the impact of acute behavioural disturbance on the anxiety levels of ED users remains unexplored.
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