| Abstract [eng] |
Introduction. Every year, more and more older people are diagnosed with dementia. Dementia has a 70-95% chance of progressing to agitated or aggressive behaviour, which is one of the biggest challenges for nurses in managing the syndrome. Managing aggressive behaviour in patients with dementia is a particularly relevant topic for nurses to ensure safe dementia nursing practice. Aim of the study: to analyse the management of aggression in patients with dementia from the experience of nurses. Objectives: 1) to identify the signs and causes of aggression in patients with dementia; 2) to identify the challenges nurses face in managing aggression; 3) to identify the actions nurses take to manage an aggressive patient. Methods and Materials. A qualitative study was conducted using semi-structured interviews. The questions of the interview schedule were developed by the researcher based on scientific literature. Nine nurses working in two different hospitals for palliative care and nursing were interviewed. Inductive thematic analysis was used to analyze the data. The results of the study showed that the participants' perceptions of aggression are supported by their unique experiences from practice. The main signs of aggression, according to the study participants, are uncontrolled anger, raised tone of voice and patient disorientation. Aggressive behaviour is provoked by the strictness of the staff, the lack of awareness of the relatives of the course and consequences of the syndrome, changes in the immediate environment, and the patients' professional experience. Aggressive behaviour manifests itself physically or verbally, which is a real challenge for the participants in the study to provide quality patient-centred care. Nurses also experience emotional stress, physical danger and communication difficulties in order to manage the aggressive behaviour of a patient with dementia. Nurses use non-medicated or medicated interventions to manage aggression. Conclusions: perceptions of aggressive behaviour are based on nurses' unique experiences of managing aggressive behaviour in patients with dementia. Nurses face daily challenges when working with aggressive dementia patients, such as: lack of awareness of dementia care among relatives, protection of self and others, side effects of medications, and identifying the cause of aggression. The main actions of the nurses can be non-medicated and medicated, but this depends on the level of aggressiveness of the patient, which the nurses assess with the support of their own experience and emotional state at the time. |
