Perceived reasons for violence toward family caregivers by relatives with schizophrenia in Eastern Turkey: a qualitative study

BACKGROUND: Previous research has found that violence towards family caregivers caring for schizophrenia patients is common due to patient-family caregiver interactions. This study aimed to investigate family caregivers' experiences of patient-initiated violence in schizophrenia and the perceived reasons for such violence. METHODS: The study was conducted using the phenomenological method, one of the qualitative research methods. The data was collected through individual in-depth interviews. The data collection ended with 12 participants. The data was analyzed using inductive qualitative content analysis to create themes and categories within the research. The confirmability, transferability, credibility and consistency of the study were checked. RESULTS: The findings revealed that family caregivers' experiences of patient-initiated violence were organized into four main themes: (1) limited illness insight and misattributions, (2) clinical symptoms and treatment non-adherence, (3) psychosocial vulnerability of the patient, and (4) family dynamics and interpersonal conflict. Caregivers often reported difficulty in identifying the causes of violence and, in some cases, attributed it to metaphysical beliefs such as the influence of jinn. Clinical factors, particularly non-adherence to treatment, hallucinations, and delusions, were perceived as major contributors to violent behavior. In addition, psychosocial vulnerabilities, including feelings of being misunderstood, loneliness, and imbalance in social life, were identified as triggers of aggression. Family-related factors, such as forcing treatment and interpersonal conflicts, were also reported to precipitate violent incidents. Overall, the findings indicate that caregivers interpret violence through a combination of clinical, cultural, and relational frameworks. CONCLUSION: This study provides comprehensive multidimensional insights into the causes, consequences and prevention of patient-related violence experienced by psychiatric nurses. The descriptions of nurses' experiences of violence illustrate the severity of violence and its negative impact on nursing care. Patient-related violence can be minimized if psychiatric nurses receive psychological support to cope with the emotions caused by the violence, focus on and address the facility's deficiencies and are trained in therapeutic interventions.