Article

The effect of a training course on mental health nurses’ attitudes on the reasons of patient aggression and its management

Maastricht University, Maestricht, Limburg, Netherlands
Journal of Psychiatric and Mental Health Nursing (Impact Factor: 0.98). 03/2006; 13(2):197 - 204. DOI: 10.1111/j.1365-2850.2006.00941.x
Source: PubMed

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.

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    • "The internal consistency of the instrument has been established in several studies [38-40]. The Cronbach’s alpha in the present study was 0.8. "
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    ABSTRACT: In psychiatry, most of the focus on patient aggression has been in adolescent and adult inpatient settings. This behaviour is also common in elderly people with mental illness, but little research has been conducted into this problem in old age psychiatry settings. The attitudes of clinical staff toward aggression may affect the way they manage this behaviour. The purpose of this study was to examine the attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient settings. A convenience sample of clinical staff were recruited from three locked acute old age psychiatry inpatient units in Melbourne, Australia. They completed the Management of Aggression and Violence Scale, which assessed the causes and managment of aggression in psychiatric settings. Eighty-five staff completed the questionnaire, comprising registered nurses (61.1%, n = 52), enrolled nurses (27.1%, n = 23) and medical and allied health staff (11.8%, n = 10). A range of causative factors contributed to aggression. The respondents had a tendency to disagree that factors directly related to the patient contributed to this behaviour. They agreed patients were aggressive because of the environment they were in, other people contributed to them becoming aggressive, and patients from certain cultural groups were prone to these behaviours. However, there were mixed views about whether patient aggression could be prevented, and this type of behaviour took place because staff did not listen to patients. There was agreement medication was a valuable approach for the management of aggression, negotiation could be used more effectively in such challenging behaviour, and seclusion and physical restraint were sometimes used more than necessary. However, there was disagreement about whether the practice of secluding patients should be discontinued. Aggression in acute old age psychiatry inpatient units occurs occasionally and is problematic. A range of causative factors contribute to the onset of this behaviour. Attitudes toward the management of aggression are complex and somewhat contradictory and can affect the way staff manage this behaviour; therefore, wide-ranging initiatives are needed to prevent and deal with this type of challenging behaviour.
    BMC Psychiatry 03/2014; 14(1):80. DOI:10.1186/1471-244X-14-80 · 2.24 Impact Factor
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    • "It has been deemed that aggressive incidents are more likely to be preceded by a combination of interpersonal and environmental antecedents than by symptomatic behavior (Shepherd & Lavender 1999). Numerous researchers have highlighted the significance of considering the multiple reasons for a inpatient aggression rather than relying on 'illness' as an justification for this aggressive behavior (Bonner et al., 2002, Spokes et al,, 2002, Whittington 2002 & Patterson et al., 2008) but the difficulties in creating such a shift in that attitude (Hahn et al., 2006) are acknowledged. Management of psychiatric inpatient aggression / violence varies widely according to the institutional policies and includes: special observation, the use of restraint, seclusion, compensatory medications and the use of de-escalation (Johnson 2001). "
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    • "Despite this gap, several authors have described an increasingly diverse number of programs and pedagogies in the field, all of which require a substantial investment in resources (Beech and Leather, 2006; Farrell and Cubit, 2005; Hahn et al., 2006; Kontio et al., 2011; Kynoch et al., 2009). Hahn et al. (2006) used a before–after design to evaluate the impact of a 5-day violence management program on mental health nurses attitudes to the causes and management of aggression. In this study, 63 individuals working in six mental health units across 3 different hospitals participated. "
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    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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