The development of aggressive and violent behavior management model in psychiatric patients for nursing personnel in general and the community hospitals

Main Article Content

Akkaradech Klinpiboon
Natladda Numpa
Theerapa Thanee
Supaporn Jansam

Abstract

          Objective To develop and evaluate the model for management aggressive and violent behaviors in psychiatric patients for nursing personnel in general and community hospitals.
          Materials and methods The research and development approach was applied in 3 stages: 1) situational analysis and review of the related factors to aggressive and violence behaviors in psychiatric patients, 2) developing the model for management aggressive and violent behaviors in psychiatric patients for nursing staff in general and community hospitals, and 3) evaluating the model. Experts assessed the model regarding the suitability, the possibility and the feasibility. The nursing personnel were purposing sampled to attend the training program and received pre/post-test in knowledge, attitude, and confi dence. The data were analysed using percentage, means, standard deviation, paired samples t-test and the qualitative data were analyzed using content analysis.
          Results The model (MInD model) consisted of 3 main processes: M-management prevention, In-intervention protection, and D-development to prevention. Experts assessed the MInD model demonstrated suitability, acceptability, and feasibility at a high level. After training, 42 nurses were observed increased signifi cantly in their knowledge, attitude, and confi dence. The outcomes at one year follow up found a decreased in incidence of aggressive and violent behaviors, a reduction in the number of referral and a decrease in the personnel injuries from the attacks.
          Conclusion The MInD model should be considered to implement in general and community hospital according to their contexts.

Downloads

Download data is not yet available.

Article Details

Section
Original article

References

1. Anderson A, West SG. Violence against mental health professionals: when the treater becomes the victim. Innov Clin Neurosci 2011;8:34-9.
2. Drach-Zahavy A, Goldblatt H, Granot M, Hirschmann S, Kostinski H. Control: patients’ aggression in psychiatric settings. Qual Health Res 2012;22:43–53.
3. Arnetz J, Hamblin L, Essenmacher L, Upfal M, Ager J, Luborsky, M. Understanding patient-to-worker violence in hospitals: a qualitative analysis of documented incident reports. J Adv Nurs 2015;71:338-48.
4. National Institution for Health and Care Excellence (NICE). Violence and aggression: short-term management in mental health, health and management in mental health, health and community settings. Manchester: National Institution for Health and Care Excellence; 2015.
5. Stevenson KN, Jack SM, O’Mara L, LeGris J. Registered nurses’ experiences of patient violence on acute care psychiatric inpatient units: an interpretive descriptive study. BMC Nurs 2015;14:35.
6. Spencer S, Stone T, McMillan M. Violence and aggression in mental health inpatient unit: an evaluation of aggression minimization programs. HNE Handover: For Nurses and Midwives 2013;3:42-48.
7. D’Ettorre G, Pellican V. workplace violence toward mental healthcare workers employed in psychiatric wards. Saf Health Work 2017;8:337-42.
8. Franz S, Zeh A, Schablon A, Kuhnert S, Nienhaus A. Aggression and violence against health care workers in Germany-a cross sectional retrospective survey. BMC Health Serv Res 2010:10:51.
9. Campbell JC, Messing JM, Kub J, Agnew J, Fitzgerald S, Fowler B, et al. Workplace violence: prevalence and risk factors in the safe at work study. J Occup Environ Med 2011;53:82-9.
10. Ceravolo DJ, Schwartz DG, Foltz-Ramos KM, Castner J. Strengthening communication to overcome lateral violence. J Nurs Manag 2012;20:599-606.
11. Mihai A, Domokos L, Tirintica R, Radu A, Nirestean A Training in management of aggressive behaviour–experience in Romania. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 468.
12. National Institution Health and Clinical Excellence (NICE). Violent and aggressive behaviours in people with mental health problems. Manchester: National Institution Health and Clinical Excellence; 2017.
13. Kynoch K, Wu CJ, Chang AM. Interventions for preventing and managing aggressive patients admitted to an acute hospital setting: a systematic review. Worldviews Evid Based Nurs 2011;8:76-86.
14. Pekara J, Trešlová M. The experiences with nurses’ trainings concerning prevention of violence in the Czech Republic in years 2010–2013. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p.:448-50.
15. Zwitter MS. Violence in the health care setting: empowering nursing students through the use of de-escalation training. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam:Kavanash; 2013. p. 440-2.
16. Snorrason J, Sævarsson GS, Bjarnason HT. Experience of staff using manual restraint techniques. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 463-4.
17. Jones D. Violence in the workplace: an endemic but not an inevitable problem of 21st century healthcare delivery. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 31-4.
18. Ciarlo SL, Moylan LB. Integration of the Audio-Visual Moylan Assessment of Progressive Aggression Tool (MAPAT) in a USA state wide training program of mental health workers. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 434-9.
19. Livingston JD, Verdun-Jones S, Brink J, Lussier P, Nicholls T. A narrative review of the effectiveness of aggression management training programs for psychiatric hospital staff. J Forensic Nurs 2010;6:15-28.
20. Melnyk BM, Fineout-Overhot E, Stillwell SB, Williamson KM. Evidence based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidencebased practice. Am J Nurs 2009;109:49-52.
21. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
22. McCann TV, Baird J, Muir-Cochrane E. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units. BMJ Psychiatry 2014:14–80.
23. Duxbury J, Hahn S, Needham I, Pulsford D. The Management of Aggression and Violence Attitude Scale (MAVAS): a cross-national comparative study J Adv Nurs 2008;62:596–606.
24. Thackrey M. Clinician confi dence in coping with patient aggression: assessment and enhancement. Professional Psychology: Research and Practice 1987;18:57-60.
25. WorkSafe Victoria. Prevention and management of aggression in health services. Victoria: WorkSafe Victoria; 2010.
26. Farrell GA, Shafi ei T, Salmon P. Facing up to “challenging behaviour”: a model for training in staff-client interaction. J Adv Nurs 2010;66:1644-55.
27. Paterson B, Leadbetter D, Miller G. Beyond zero tolerance: a varied approach to workplace violence. Br J Nurs 2005;14:746-51.
28. Sethi D, Habibula S, McGee K, Peden M, Bennett S, Hyder AA, et al. Guidelines for conducting community surveys on injuries and violence. Geneva: World Health Organization; 2004.
29. McDonnell AA, Gould A, Adams T, Sallis J, Anker R. Staff training in physical intervention: a systematic literature review. Bath: Studio 3 training system; 2014.
30. Middleby-Clements JL, Grenyer BF. Zero tolerance approach to aggression and its impact upon mental health staff attitudes. Aust N Z Psychiatry 2007;41:187-91.
31. Chinn PL, Kramer MK. Integrated theory & knowledge development in nursing. 8th e dition. St Louis: Elsevier; 2008.
32. Sudthae K. The development of forms of academic administration for small schools. Mahasarakham: Maha sarakham Rajabhat University; 2010. (in Thai)
33. Baker SN. Management of acute afi tation in the emergency department. Adv Emerg Nurs J 2012;34:306-18.
34. Jones D. Violence in the workplace: an endemic but not an inevitable problem of 21st century healthcare delivery. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 31-4.
35. Guay S, Boyer R, Jarvis J, Dugal N. Evaluation of changes in perceived self-effi cacy in managing patient aggression after completing workplace prevention training. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 459-62.
36. Bowers L, Nijman H, Allan T, Simpson A, Warren J, Turner L. Prevention and management of aggression training and violent incidents on U.K. acute psychiatric wards. Psychiatr Serv 2006;57:1022-6.
37. Karpilovsky H. Reducing aggression on a psychiatric unit through interdisciplinary staff education. In: Callaghan P, Oud N, Bjorngaard JH, Nijman H, Palmstierna T, Almvik R, et al., editors. Proceedings of the 8th European Congress on Violence in Clinical Psychiatry. 2013 Oct 23-26; Ghent, Belgium. Amsterdam: Kavanash; 2013. p. 452.
38. Pekar BC, Gillespie GL. Workplace violence: a call for action. J Hospital Adm 2014;3:34-40.
39. Saimai W, Thanjira S, Phasertsukjinda N. Workplace violence and its management by nursing personnel in emergency department. Ramathibodi Nursing Journal 2010;6:121-35. (in Thai)