Nursing strategies for implementing psychosocial interventions to address violence behavior in schizophrenia: a scoping review
BMC Nurs. 2025 May 8;24(1):503. doi: 10.1186/s12912-025-03145-2.
ABSTRACT
BACKGROUND: Psychosocial interventions are crucial in managing violent behavior problems in people with schizophrenia, considering the high risk to self and others. Although drug therapy plays an important role, psychotherapy approaches offer holistic solutions in reducing violent behavior that is complex and often resistant to treatment. Therefore, a comprehensive review of the literature on these psychosocial interventions is necessary to evaluate the various approaches that have been developed.
OBJECTIVE: This study aims to map and synthesize existing literature on psychosocial interventions designed to reduce violent behavior in patients with schizophrenia.
METHODS: A scoping review was carried out by searching for articles from the CINAHL, PubMed, and Scopus databases using the keywords “schizophrenia”, “nursing”. “psychosocial intervention”, and “violence”. Inclusion criteria included studies published in English using original research, reporting the results of a nursing intervention, full text, and a publication period of the last five years (2019-2024). Data was extracted using manual tables, and analysis was carried out descriptively qualitatively.
RESULTS: There were 12 articles that met the inclusion criteria and discussed various psychosocial interventions to reduce violent behavior in people with schizophrenia. The results showed that five types of nursing strategies, logotherapy, assertive therapy, forgiveness therapy, cognitive behavioral therapy (CBT) and social skills training (SST), and assertive communication and de-escalation training, consistently resulted in significant reductions in violent behavior.
CONCLUSION: This scoping review underscores the need for a comprehensive approach to managing violent behavior in schizophrenia by utilizing psychosocial interventions that have been proven to be effective. However, the limited number of studies, heterogeneity in intervention methods, and variability in outcome assessments warrant careful interpretation of the results. Nursing implications include improvements in training and support for nurses to implement these interventions in daily clinical practice. Recommendations for future research include the need for more in-depth studies to explore effective intervention mechanisms as well as improvements in methodologically more robust study designs.
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