The effect of a training course on mental health nurses’ attitudes on the reasons of patient aggression and its management
ABSTRACT Aggression in healthcare systems poses a major problem for nurses because they are the most susceptible to suffer violence. Studies demonstrate that attitudes of nurses influence their behaviour regarding aggression and violence. Training programmes can positively change nurses’ attitudes. This quasi-experimental study aimed to examine the effects of a systematic training course in aggression management on mental health nurses’ attitudes about the reasons for patients’ aggression and on its management. Sixty-three nurses (29 in the intervention and 34 in the control group) participated in this quasi-experimental pre-test and post-test study. The attitude of the participants of a training course was recorded by the German version of the Management of Aggression and Violence Attitude Scale (MAVAS). No significant attitude changes occurred in the intervention group at post-test. It is concluded that trainings intending to influence attitudes regarding the reason for patient aggression should consider the impact of the pedagogical quality of the training course, organizational support, and the user's perception. Moreover, it remains questionable to what extent a single instrument of measurement can record attitude changes.
Full-textDOI: · Available from: Ruud J G Halfens, Jul 05, 2015
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ABSTRACT: BACKGROUND: Patient aggression is a common source of occupational violence in emergency departments. Staff attitudes regarding the causes for aggression influence the way they manage it. The Management of Clinical Aggression - Rapid Emergency Department Intervention is a 45min educational program that aims to promote the use of de-escalation techniques and effective communication skills to prevent patient aggression. OBJECTIVE: We sought to evaluate the impact of the program on staff attitudes regarding the prevention and early management of patient aggression. DESIGN: A mixed methods approach was used including a pre-test post-test survey of training participants and individual interviews with key stakeholders. SETTING AND SAMPLE: The setting was public sector hospital emergency departments located in metropolitan and regional Victoria, Australia. A convenience sample of eighteen emergency departments was recruited via the Victorian Department of Health. PARTICIPANTS: Survey participants were nurses and midwives who were employed at the study sites. Interview participants were a purposive sample of nurse unit managers and trainers. METHODS: The Management of Aggression and Violence Attitude Scale was administered to training participants immediately before and 6-8 weeks after training. Semi-structured telephone interviews with trainers and managers occurred 8-10 weeks after the intervention. RESULTS: Four hundred and seventy one participants completed the pre-test and post-test. Statistically significant shifts were observed in 5/23 items (Wilcoxon Signed Ranks Test: p≤0.01). Despite training, participants were undecided if it was possible to prevent patient aggression, and continued to be unsure about the use of physical restraint. Twenty-eight (82.3%) of managers' and trainers' eligible to be interviewed provided their perceptions of the impact of the program. Overall, these perceptions were consistent with the significant shifts observed in the survey items. CONCLUSION: There was limited evidence to demonstrate that the program significantly modified staff attitudes towards the prevention of patient aggression using the Management of Aggression and Violence Attitude Scale. Additional survey items that specifically measure staff attitudes about the use of restraint in emergency settings are needed to better understand decision making about restraining practices. Further work is indicated to quantify the impact of training in practice.International journal of nursing studies 02/2013; 50(11). DOI:10.1016/j.ijnurstu.2013.01.007 · 2.25 Impact Factor
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ABSTRACT: Nurses' attitudes about the causes and management of aggression affects their choice of intervention. We aimed to compare the attitudes held by patients and staff in a forensic mental health service with the Management of Aggression and Violence Attitudes Scale, and examine the factor validity of the tool in this setting by conducting a prospective comparative questionnaire survey. Staff (n = 72) and patient (n = 98) attitudes differed to a limited extent. Confirmatory factor analysis refuted the previously reported structure of the tool. Exploratory factor analysis suggested three underlying factors related to modifiability of aggression, hands on management, and hands off management. Patients were more optimistic than nurses about the modifiability of aggressive behaviour. Male patients and those with diagnoses other than personality disorder were significantly more likely to agree about modifiability than controls. Forensic inpatients recognize the need for the use of a range of techniques to prevent and manage aggression and violence, but selected groups are most likely to believe that aggression is modifiable. Prevention and management of aggression training should emphasize the modifiability of aggressive behaviour. The development of measures of modifiability and management style would assist in the evaluation of training and would offer new avenues for research.International journal of mental health nursing 11/2012; 22(6):532-544. DOI:10.1111/j.1447-0349.2012.00888.x · 2.01 Impact Factor