Systematic review of studies of mental health nurses' experience of anger and of its relationships with their attitudes and practice

Introduction: Emotional regulation is important in mental health nursing practice, but individual emotions may require different regulation strategies. There is ample evidence that nurses experience anger specifically during their work, for example when experiencing patient aggression. It is, therefore, important to consolidate what is known about how anger manifests in mental health nursing practice. Aim: We aimed to systematically identify, evaluate and synthesize results from studies about mental health nurses and anger, where anger was measured objectively. Methods: Systematic literature review based on PRISMA guidelines. Results: We identified 12 studies. A range of validated and nonvalidated instruments was used. Mental health nurses may have lower levels of anger than normative samples, but anger is commonly reported as an issue for them. Anger was studied in relation to its links with (1) clinical management of patients, notably violence containment; and (2) employment issues more generally, notably job motivation. Anger is related to nurses’ attitudes about the acceptability of coercion, but there is no evidence that it results in more coercion. Implications for practice: Nurses should be aware of the potential influence of anger on their practice. Anger, specifically, should be considered when supporting mental health nurses, for example in clinical supervision. Emotional regulation training should target anger