| Abstract [eng] |
SUMMARY Vilnius University Faculty of Medicine Masters's Degree Nursing Programme MENTAL HEALTH NURSES EXPERIENCE OF AGGRESSION AND APPROACH TO THE MANAGEMENT OF AGGRESSION AND VIOLENCE IN THE HOSPITAL Master's degree final scientific research work Author of the master's degree scientific research work: Agnė Čiupailienė Head of the master's degree scientific research work: prof. habil. dr. Danutė Kalibatienė Vilnius, 2016 Keywords: mental health nurse, patient aggression, violence, questionnaires POPAS and MAVAS. Aim of the Research. To analyse aggression experienced by mental health nurses and their attitude towards aggression and violence management at the hospital. Tasks. To analyse types and frequency of aggression experienced by nurses, who work in psychiatry departments, in their professional activity. To evaluate the attitude of nurses, who work in psychiatry departments, towards means of aggression and violence management. To analyse the attitude of patients, who are treated in psychiatry departments, towards means of aggression and violence management. To compare the attitude of nurses and patients towards manifestations of aggression at psychiatry departments. Materials and Methods. The research was carried out in two Vilnius hospitals of psychiatry. The research involved 185 respondents in total, out of which, 99 patients with mental health disorders and 86 mental health nurses. The survey was carried out using aggression and violence evaluation questionnaires POPAS and MAVAS. Statistical analysis of data. Quantitative features described in averages and their standard errors. Kruskal – Wallis test was used to compare averages for more than two independent samples. For the comparison of two independent samples of averages – T test. The difference was considered to be statistically reliable, when the significance level p < 0.05. Results. It was determined that all nurses have experienced patient aggression, usually verbal (79.1%), threatening verbal (53.5%), degrading aggressive behaviour (41.9%), provocative aggressive behaviour (34.9%), passive aggressive behaviour (30.2%), and threatening physical aggression (32.6%). Most rarely, nurses experienced sexual assault/rape (2.3%). The frequency of nurse incapacity, related to patient aggression, was 2.4%. Patients claim that aggression should be managed more effectively; alternative isolation and physical constraint means and negotiation method should be used more often. Conclusions. Two thirds of mental health nurses experience verbal aggression, a half – threatening verbal aggression, almost the third of all nurses – degrading aggressive, passive, or provocative behaviour and threatening psychical aggression. The majority of nurses agree that patients cannot be left unattended in case of aggressive behaviour, that limited environment and poor communication can provoke aggressive behaviour, that patient aggression could be managed more effectively, using medication, physical constraint, and isolation. According to patients, factors in the hospital cause aggression: limited environment, poor communication among patients and employees, use of medication to manage aggression, unduly common practice of patient physical constraint and isolation. The attitude of nurses and patients towards aggression management differs in many aspects. Patients believe that hospital environment influence manifestations of aggression and nurse deny it. According to patients, used methods of aggression management are insufficient, and nurses have the opposite view. Patients believe that using medication can provoke aggressive behaviour, and nurses disagree. Patients would like to reduce the use of physical constraint and isolation, and according to nurses, these methods could be used more often. |
