Aggressive Patient Behaviors Related to Medical Care: A Cross-Sectional Self-Report Survey

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Objective: To examine the self-reported prevalence of aggressive and/or disruptive behaviors by patients as related to their medical care.

Method: In a cross-sectional, consecutive sample of internal medicine outpatients (N = 397), respondents reported on 17 aggressive and/or disruptive behaviors related to their medical care. Data were collected during November 2010.

Results: In this sample, 48.9% of respondents endorsed at least 1 of the proposed aggressive behaviors; 9.1% endorsed 1 behavior, 20.4% endorsed 2 behaviors, 10.3% endorsed 3 behaviors, 5.5% endorsed 4 behaviors, and 3.5% endorsed 5 or more behaviors (the maximum being 11). The most commonly reported behaviors were talking negatively about medical personnel to family (41.3%) and friends (39.5%), threatening to hit or strike medical personnel (7.1%), and refusing to pay a bill because of dissatisfaction or anger (6.8%). No participant reported being escorted off premises by security or being charged with assault in a medical setting. For those who reported 1 or more aggressive behaviors, there were no gender differences, but younger and better educated patients were more likely to report such behaviors.

Conclusions: While the majority of patients do not evidence aggressive behaviors related to their medical care, a small minority do report such behavior, some of which can be disruptive as well as dangerous.

Prim Care Companion CNS Disord 2011;13(4):doi:10.4088/PCC.11m01160

Submitted: February 8, 2011; accepted April 1, 2011.

Published online: August 11, 2011 (doi:10.4088/PCC.11m01160).

Corresponding author: Randy A. Sansone, MD, Sycamore Primary Care Center, 2115 Leiter Rd, Miamisburg, Ohio (

Prim Care Companion CNS Disord 2011;13(4):doi:10.4088/PCC.11m01160