Nursing Care of Patients with Substance Use, Aggressive Behavior, and High Risk of Violence : Case Study 2 Case.

Abstract

     This study was comparative case analysis of two patients, aimed at exploring nursing care for substance users exhibiting aggressive behaviors with a high risk of violence, treated at the Emergency Department of Ban Fang Hospital. Patients were selected based on positive methamphetamine screening results and a history of aggressive behaviors posing potential harm to family and community. Data were collected from patients, relatives, and medical records, including symptom assessment, history-taking, and physical examination from the acute care phase. Health status was assessed using Gordon’s Functional Health Patterns combined with the nursing process to identify nursing diagnoses and plan care according to the nursing process and the seven aspects of professional nursing clinical care, ensuring comprehensive care planning.

     Both patients received emergency nursing care until stabilization, followed by referral according to severity and post-discharge follow-up to prevent relapse. Case 1 involved a 48-year-old Thai male methamphetamine user with psychotic symptoms, paranoia, and severe aggressive behavior. After treatment with short-acting and long-acting injectable antipsychotics, oral antipsychotics, mood stabilizers, and psychosocial therapy, his symptoms stabilized, allowing safe return to his family. Case 2 involved a 44-year-old Thai male methamphetamine user with severe aggression, psychosis, hallucinations, and paranoia, resulting in harmful behavior towards others. He received inpatient treatment at a psychiatric hospital, including oral and long-acting injectable antipsychotics, mood stabilizers, and psychosocial therapy, which improved his emotional and behavioral control, though residual delusional thoughts remained. Compared to Case 1, his emotional control was less stable, likely due to prolonged and high-volume substance use and stress from family rejection. Discharge planning for both cases required referral to community network partners to ensure maximum safety, as both patients had psychiatric symptoms and high risk of violence.