Citation

Visscher AJ, van Meijel B, Stolker JJ, Wiersma J, Nijman H. J. Clin. Nurs. 2011; 20(23-24): 3414-3422.

Affiliation

Authors: Ada JM Visscher, MSc, RN, Scientific Nurse, Altrecht Institute for Mental Health Care, Vesalius, Centre for Acquired Brain Injury, Den Dolder and Research Group Mental Health Nursing, Inholland University of Applied Sciences; Berno van Meijel, PhD, Associate Professor in Mental Health Nursing, Research Group Mental Health Nursing, Inholland University of Applied Sciences; Joost J Stolker, PhD, MD, Medical Doctor and Medical Director, Arkin Institute for Mental Health Care, Amsterdam; Jan Wiersma, MD, Medical Doctor, UMC St. Radboud, Department of Psychiatry, Nijmegen and Private (Neuro) Psychiatric Practice, Arnhem; Henk Nijman, PhD, Senior Researcher, Altrecht Institute for Mental Health Care, Division of Ortho and Forensic Psychiatry, Den Dolder and Professor of Forensic Psychology, Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands.

Copyright

(Copyright © 2011, John Wiley and Sons)

DOI

10.1111/j.1365-2702.2011.03800.x

PMID

21752131

Abstract

Objective.  To study the prevalence, nature and determinants of aggression among inpatients with acquired brain injury. Background.  Patients with acquired brain injury often have difficulty in controlling their aggressive impulses. Design.  A prospective observational study design. Methods.  By means of the Staff Observation Aggression Scale-Revised, the prevalence, nature and severity of aggressive behaviour of inpatients with acquired brain injury was assessed on a neuropsychiatric treatment ward with 45 beds. Additional data on patient-related variables were gathered from the patients' files. Results.  In total, 388 aggressive incidents were recorded over 17 weeks. Of a total of 57 patients included, 24 (42%) patients had engaged in aggressive behaviour on one or more occasions. A relatively small proportion of patients (n = 8; 14%) was found to be responsible for the majority of incidents (n = 332; 86%). The vast majority of aggression incidents (n = 270; 70%) were directly preceded by interactions between patients and nursing staff. In line with this, most incidents occurred at times of high contact intensity. Aggressive behaviour was associated with male gender, length of stay at the ward, legal status and hypoxia as the cause of brain injury. Conclusion.  Aggression was found to be highly prevalent among inpatients with acquired brain injury. The results suggest that for the prevention of aggression on the ward, it may be highly effective to develop individually tailored interventions for the subgroup with serious aggression problems. Relevance to clinical practice.  Insight into the frequency, nature and determinants of aggressive behaviour in inpatients with acquired brain injury provides nurses with tools for the prevention and treatment of aggressive behaviour.

Language: en