Citation

Zeller A, Dassen TWN, Kok G, Needham I, Halfens RJ. J. Clin. Nurs. 2011; 20(17-18): 2469-2478.

Affiliation

Authors: Adelheid Zeller, MNS, NT, RN, Head of Bachelor of Science in Nursing, Department of Health, University of Applied Sciences, St. Gallen, Switzerland; Theo Dassen, PhD, RN, Head of Department of Nursing Science, Centre for the Humanities and Health Sciences, Department of Nursing Science, Charité-Universitätsmedizin, Berlin, Germany; Gerjo Kok, PhD, Professor of Applied Psychology, Department of Work and Social Psychology, Faculty of Psychology, Universiteit Maastricht, Maastricht, The Netherlands; Ian Needham, PhD, NT, RN, Nursing Scientist, Centre of Psychiatry Rheinau, Rheinau, Switzerland; Ruud JG Halfens, PhD, FEANS, Professor, Faculty of Health, Medicine, and Lifesciences, Department of Health Care and Nursing Science, Universiteit Maastricht, Maastricht, The Netherlands.

Copyright

(Copyright © 2011, John Wiley and Sons)

DOI

10.1111/j.1365-2702.2011.03722.x

PMID

21682784

Abstract

Aims and objectives.  This study explored caregivers' perspectives regarding the conditions and situations of resident aggression and practical strategies caregivers use to deal with aggression. Background.  Working in a nursing home is associated with a high risk to experience aggression from residents or patients. Despite existing recommendations for dealing with aggression there is a lack of information about caregivers' ways of dealing with it in practice. Design.  A qualitative study with focus group method was conducted. Method.  Five focus group interviews, with a total of 30 participants, from nursing homes in Switzerland were undertaken employing a semi-structured interview guideline. For analysing the data, qualitative content analysis was employed. Results.  Analysis of the data produced three themes with additional sub-themes. One main theme concerns the explanations of the caregivers in regard to the occurrence of aggressive behaviour. This theme is subdivided into two areas, the contributory resident related factors and the caregiver related factors. The measures for handling aggressive behaviour are illustrated in the second theme 'dealing with residents'. The third theme refers to the strategies of the caregivers when confronted with aggressive behaviour -'self-protection' and 'coping with the situation'. Conclusion.  Caregivers use a broad spectrum of interventions for reducing aggression, some of which are recommended by guidelines but often ignore the link between aggressive behaviour and physiological issues like pain or elimination. The caregivers only very rarely linked their practical knowledge about aggressive behaviour with theoretical knowledge. Relevance to clinical practice.  The results give insight into the caregivers' perspectives on factors leading to aggression and their coping strategies. Caregivers are informed about relevant reasons for aggressive behaviour and its management, but do not apply a systematic approach. Furthermore, the anxiety of caregivers involved in aggression incidents is an under examined area.

Language: en