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Aggressive Incidents (aggressive + incident)
Selected AbstractsStaff gender ratio and aggression in a forensic psychiatric hospitalINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2006Michael Daffern ABSTRACT:, Gender balance in acute psychiatric inpatient units remains a contentious issue. In terms of maintaining staff and patient safety, ,balance' is often considered by ensuring there are ,sufficient' male nurses present on each shift. In an ongoing programme of research into aggression, the authors investigated reported incidents of patient aggression and examined the gender ratio on each shift over a 6-month period. Contrary to the popular notion that a particular gender ratio might have some relationship with the likelihood of aggressive incidents, there was no statistically significant difference in the proportion of male staff working on the shifts when there was an aggressive incident compared with the shifts when there was no aggressive incident. Further, when an incident did occur, the severity of the incident bore no relationship with the proportion of male staff working on the shift. Nor did the gender of the shift leader have an impact on the decision to seclude the patient or the likelihood of completing an incident form following an aggressive incident. Staff confidence in managing aggression may be influenced by the presence of male staff. Further, aspects of prevention and management may be influenced by staff gender. However, results suggest there is no evidence that the frequency or severity of aggression is influenced by staff gender ratio. [source] Measuring aggression with the staff observation aggression scale , revisedACTA PSYCHIATRICA SCANDINAVICA, Issue 2002H. Nijman Objective:, The staff observation aggression scale (SOAS; Palmstierna & Wistedt, 1987) was developed to measure nature, number, as well as severity of aggressive incidents. In 1999, a revised version of the SOAS (i.e. the SOAS-R), with a more fine-grained severity scoring system, was presented. In the current paper, the development and testing of the revised severity scores of the SOAS-R are addressed. Method: In two consecutive studies, staff members recorded inpatient aggression on SOAS-R forms, but also expressed their opinion about the severity of incidents on 100 mm visual analogue scales (VASs). Correlations were calculated between SOAS and SOAS-R severity scores, on the one hand, and clinical judgements of severity, on the other. Results:, In both studies, revised SOAS severity scores were more closely related to clinical judgements of aggression severity than the original ones. Conclusion: The SOAS-R is a promising tool for research on the prevalence, severity and determinants of inpatient aggression. [source] Violence in a general hospital: comparison of assailant and other assault-related factors on accident and emergency and inpatient wardsACTA PSYCHIATRICA SCANDINAVICA, Issue 2002S. Winstanley Objective:, This study sought to compare the characteristics of aggressive incidents occurring on inpatient (medical and surgical) wards with those occurring in the accident and emergency department in terms of assailant, employee and other factors. Method:, A prospective interview-based survey design was adopted. Forty-eight assaulted staff were interviewed about 69 incidents within 7 days on average of the incident occurring. The presence or absence of various assailant, employee, situation, interaction and outcome factors derived from the UK Health Services Advisory Committee's model was compared between the two settings. Results:, Inpatient ward incidents were significantly more likely to have the following characteristics: female perpetrator, perpetrator aged over 70 years, daytime occurrence in a restricted area, resolved by support from other health care staff. Conclusion:, Aggression frequently occurs on inpatient (medical and surgical) wards of a general hospital. Aggression management training for staff working in both accident and emergency and inpatient settings should be cognisant of the similarities and differences within general health care specialisms. [source] Guardians and handlers: the role of bar staff in preventing and managing aggressionADDICTION, Issue 6 2005Kathryn Graham ABSTRACT Aims To identify good and bad behaviors by bar staff in aggressive incidents, the extent these behaviors apparently reflect aggressive intent, and the association of aggressive staff behavior with level of aggression by patrons. Design, setting and participants Data on staff behavior in incidents of aggression were collected by 148 trained observers in bars and clubs on Friday and Saturday night between midnight and 2 a.m. in Toronto, Canada. Behaviors of 809 staff involved in 417 incidents at 74 different bars/clubs were analysed using descriptive statistics and three-level hierarchical linear modeling (HLM) analyses. Measurements Observers' ratings of 28 staff behaviors were used to construct two scales that measured escalating/aggressive aspects of staff behavior. Apparent intent level for bar staff was dichotomized into (1) no aggressive intent versus (2) probable or definite aggressive intent. Five levels of patron aggression were defined: no aggression, non-physical, minor physical, moderate physical and severe physical. Findings The most common aggressive behaviors of staff were identified. Staff were most aggressive when patrons were either non-aggressive or highly aggressive and staff were least aggressive when patrons exhibited non-physical aggression or minor physical aggression. Taking apparent intent into consideration decreased staff aggression scores for incidents in which patrons were highly aggressive indicating that some aggression by staff in these instances had non-aggressive intent (e.g. to prevent injury); however, apparent intent had little effect on staff aggression scores in incidents with non-aggressive patrons. Conclusion Although there is potential for staff to act as guardians or handlers, they often themselves became offenders when they responded to barroom problems. The practical implications are different for staff aggression with nonaggressive patrons versus with aggressive patrons. [source] Staff gender ratio and aggression in a forensic psychiatric hospitalINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2006Michael Daffern ABSTRACT:, Gender balance in acute psychiatric inpatient units remains a contentious issue. In terms of maintaining staff and patient safety, ,balance' is often considered by ensuring there are ,sufficient' male nurses present on each shift. In an ongoing programme of research into aggression, the authors investigated reported incidents of patient aggression and examined the gender ratio on each shift over a 6-month period. Contrary to the popular notion that a particular gender ratio might have some relationship with the likelihood of aggressive incidents, there was no statistically significant difference in the proportion of male staff working on the shifts when there was an aggressive incident compared with the shifts when there was no aggressive incident. Further, when an incident did occur, the severity of the incident bore no relationship with the proportion of male staff working on the shift. Nor did the gender of the shift leader have an impact on the decision to seclude the patient or the likelihood of completing an incident form following an aggressive incident. Staff confidence in managing aggression may be influenced by the presence of male staff. Further, aspects of prevention and management may be influenced by staff gender. However, results suggest there is no evidence that the frequency or severity of aggression is influenced by staff gender ratio. [source] Effect of Person-Centered Showering and the Towel Bath on Bathing-Associated Aggression, Agitation, and Discomfort in Nursing Home Residents with Dementia: A Randomized, Controlled TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004Philip D. Sloane MD Objectives: To evaluate the efficacy of two nonpharmacological techniques in reducing agitation, aggression, and discomfort in nursing home residents with dementia. The techniques evaluated were person-centered showering and the towel bath (a person-centered, in-bed bag-bath with no-rinse soap). Design: A randomized, controlled trial, with a usual-care control group and two experimental groups, with crossover. Setting: Nine skilled nursing facilities in Oregon and six in North Carolina. Participants: Seventy-three residents with agitation during bathing (69 completed the trial) and 37 nursing assistants who bathed them. Measurements: Agitation and aggression were measured using the Care Recipient Behavior Assessment; discomfort was measured using a modification of the Discomfort Scale for Dementia of the Alzheimer Type. Raters who were blinded to subject status coded both from videotaped baths. Secondary measures of effect included bath duration, bath completeness, skin condition, and skin microbial flora. Results: All measures of agitation and aggression declined significantly in both treatment groups but not in the control group, with aggressive incidents declining 53% in the person-centered shower group (P<.001) and 60% in the towel-bath group (P<.001). Discomfort scores also declined significantly in both intervention groups (P<.001) but not in the control group. The two interventions did not differ in agitation/aggression reduction, but discomfort was less with the towel bath (P=.003). Average bath duration increased significantly (by a mean of 3.3 minutes) with person-centered showering but not with the towel bath. Neither intervention resulted in fewer body parts being bathed; both improved skin condition; and neither increased colonization with potentially pathogenic bacteria, corynebacteria, or Candida albicans. Conclusion: Person-centered showering and the towel bath constitute safe, effective methods of reducing agitation, aggression, and discomfort during bathing of persons with dementia. [source] Experimental study of the differential effects of playing versus watching violent video games on children's aggressive behaviorAGGRESSIVE BEHAVIOR, Issue 3 2008Hanneke Polman Abstract There is great concern about the effects of playing violent video games on aggressive behavior. The present experimental study was aimed at investigating the differential effects of actively playing vs. passively watching the same violent video game on subsequent aggressive behavior. Fifty-seven children aged 10,13 either played a violent video game (active violent condition), watched the same violent video game (passive violent condition), or played a non-violent video game (active non-violent condition). Aggression was measured through peer nominations of real-life aggressive incidents during a free play session at school. After the active participation of actually playing the violent video game, boys behaved more aggressively than did the boys in the passive game condition. For girls, game condition was not related to aggression. These findings indicate that, specifically for boys, playing a violent video game should lead to more aggression than watching television violence. Aggr. Behav. 34:256,264, 2008. © 2007 Wiley-Liss, Inc. [source] Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviourJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2008N. H. Tenneij Abstract Background Inpatient aggression in treatment facilities for persons with intellectual disability (ID) can have aversive consequences, for co-clients and staff, but also for the aggressors themselves. To manage and eventually prevent inpatient aggressive incidents, more knowledge about their types and characteristics is necessary. Method In four facilities, totalling 150 beds, specialized in the treatment of adults with mild ID or severe challenging behaviour, aggressive incidents were registered during 20 weeks using the Staff Observation Aggression Scale-Revised. Characteristics of auto-aggressive and outwardly directed incidents and differences in their incidence in male and female clients in these facilities were compared. Results During the observation period of 20 weeks, 639 aggressive incidents were documented. Most of these (71%) were outwardly directed, predominantly towards staff, while most of the remaining incidents were of an auto-aggressive nature. Of the 185 clients present during the observation period, 44% were involved in outwardly directed incidents (range per client 1,34), and 12% in auto-aggressive incidents (range per client 1,92). Auto-aggressive and outwardly directed incidents differed regarding source of provocation, means used during the incident, consequences of the incident and measures taken to stop the incident. The proportion of men and women involved in each type of incident was comparable, as well as the majority of the characteristics of outwardly directed incidents caused by men and women. Conclusions Although approximately half of all clients were involved in aggressive incidents, a small minority of clients were responsible for the majority of incidents. Therefore, better management and prevention of aggressive incidents for only a small group of clients could result in a considerable overall reduction of aggressive incidents in treatment facilities. Comparability of aggressive behaviour in these facilities shown by men and women and differences in characteristics of auto-aggressive and outwardly directed incidents are discussed. [source] Aggression and violence in mental health services: categorizing the experiences of Irish nursesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2007J. MAGUIRE msc ba(hons) ffnrcsi rpn rgn dip There is growing evidence that nurses in mental health services are likely to be victims of violence or aggression. One of the key difficulties in comparing international findings, however, has been that there has been an inadequate categorization of the types of incident to which staff are exposed. The current study aimed to identify the types of violent or aggressive incidents that staff in Irish Mental Health Services were exposed to within a 1-month long period. A cross-sectional study was undertaken with all nurses working in one of the Mental Health Services in Ireland, serving both an urban and rural population. Data were collected through a questionnaire (Scale of Aggressive and Violent Experiences) adapted from the Perceptions of Prevalence of Aggression Scale. The questionnaire was designed to collect data relating to both personal and professional demographics of the sample as well as experiences of aggressive or violent incidents respondents may have encountered in their work situation. There was a response rate of 31%. Data were analysed utilizing SPSS-11. Both descriptive and inferential analyses were undertaken. The relevant data were subjected to a series of one-way anovas and chi-squared analysis. The findings suggest that nursing staff in this Mental Health Service experienced high levels of verbal aggression, with distinctions obvious between threatening and non-threatening aggression, suggesting discernment in terms of intentionality. Additionally, respondents encountered greater levels of covert or indirect violence or aggression than forms that were overtly directed towards staff. The implications are discussed in relation to both policy and practice. [source] Characteristics of aggression in a German psychiatric hospital and predictors of patients at riskJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2007R. KETELSEN md phd This study investigated the aggressive behaviour of all mentally ill patients within a whole psychiatric hospital with a catchment area of 325 000 inhabitants over a 1-year period (i) to assess the 1-year prevalence and characteristics of aggressive episodes and index inpatients, and (ii) to identify predictors of patients at risk by a multivariate approach. Staff Observation of Aggression Scale was used to assess aggressive behaviour. Characteristics of index inpatients were compared with those of non-index inpatients. Logistic regression analysis was applied to identify risk factors. A total of 171 out of 2210 admitted patients (7.7%) exhibited 441 aggressive incidents (1.7 incidents per bed per year). Logistic regression analyses revealed as major risk factors of aggression: diagnoses (organic brain syndromes OR = 3.6, schizophrenia OR = 2.9), poor psychosocial living conditions (OR = 2.2), and critical behaviour leading to involuntary admission (OR = 3.3). Predictors of aggressive behaviour can be useful to identify inpatients at risk. Nevertheless, additional situational determinants have to be recognized. Training for professionals should include preventive and de-escalating strategies to reduce the incidence of aggressive behaviour in psychiatric hospitals. The application of de-escalating interventions prior to admission might be effective in preventing aggressive behaviour during inpatient treatment especially for patients with severe mental disorders. [source] The effectiveness of two interventions in the management of patient violence in acute mental inpatient settings: report on a pilot studyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2004I. NEEDHAM rn nt mnsc Systematic risk assessment and training courses have been suggested as interventions to deal with patient violence in psychiatric institutions. A dual centre prospective feasibility study was conducted on two Swiss psychiatric admission wards to test the hypothesis that such interventions will reduce the frequency and severity of violent events and coercion. A systematic aggression risk assessment, in combination with a standardized training course in aggression management was administered and the frequency and severity of aggressive incidents and the frequency of coercive measures were registered. The incidence rates of aggressive incidents and attacks showed no significant reduction from the baseline through risk prediction and staff training, but the drop in coercive measures was highly significant. A ,ward effect' was detected with one ward showing a decline in attacks with unchanged incidence rates of coercion and the other ward showing the opposite. The severity of the incidents remained unchanged whilst the subjective severity declined after the training course. We conclude that a systematic risk assessment and a training course may assist in reducing the incidence rate of coercive measures on psychiatric acute admission wards. Further testing of the interventions is necessary to measure the effect of the training alone and to counteract ,ward effects'. [source] Injecting risk behaviour and related harm among men who use performance- and image-enhancing drugsDRUG AND ALCOHOL REVIEW, Issue 6 2008BRIONY LARANCE Abstract Introduction and Aims. Performance- and image-enhancing drugs have the potential to be a significant public health issue. Detailed data on PIEDs injection are difficult to obtain because of the illicit and unsupervised way in which many PIEDs are used, and the hidden nature of the group. Our study examines the patterns of use, risk behaviours and related harm associated with PIEDs injection. We also report the ways in which PIEDs users currently seek injecting equipment and harm-reduction advice. Design and Method. Data were obtained via a structured questionnaire administered in face-to-face interviews with 60 men who used PIEDs (primarily anabolic androgenic steroids) for non-medical purposes. Results. Although the rates of needle sharing were low (5%), the men more frequently reported re-use of needles/equipment, injecting from a shared container (bladders, vials, etc.), injecting other illicit drugs, injecting insulin and targeting small muscle groups. Self-reports of being hepatitis C antibody positive were associated with lifetime use of heroin and injection of other illicit drugs. All HIV positive participants were gay/bisexual men. Participants reported a range of other injection-related injuries and diseases such as fevers, scarring and abscesses. ,Risky' injectors (38% of participants) were more likely to initiate PIEDs use at a younger age, use PIEDs in a larger number of cycles per year and report involvement in a violent/aggressive incident than ,low risk' injectors and report involvement in a violent/aggressive incident than ,low risk' injectors. Participants mainly reported seeking information about PIEDs from internet sites (62%) and friends (55%). Conclusions. An over-reliance on personal networks and internet forums limits this groups' access to objective harm reduction advice and primary care services. Targeted, PIEDs-specific interventions are needed. [source] | |||||||||||||