The outcome of a training programme (RESPECT) on staff’s attitudes towards causes and management of aggression in a Regional Referral Hospital of Northern Uganda

Introduction Occupational violence has been demonstrated to impact negatively on the well‐being of nurses and patients. Staff attitudes towards causes and management of patients’ aggression influence their practice. Training is likely to influence attitudes towards aggression; however, Uganda's health system lacks adequate resources to provide aggression management training for staff. Aim To assess the impact of a training programme (RESPECT) on staff attitudes towards causes and management of patient's aggression in a Ugandan hospital. Methods This study used a mixed‐methods convergent design. A convenience sample of nurses and support staff employed in the psychiatric ward and other services across the hospital (N = 90) completed the Management of Aggression and Violence Attitude Scale (MAVAS) pre‐ and post‐training. The views of a smaller sample (n = 35) were captured via interviews and focus groups and analysed using thematic analysis. Results Participants reported greater agreement with patients’ physical and social environment (external and situational causative models) as factors influencing patient's aggression. Qualitative findings substantiated the results identified in the survey. Attitudes towards seclusion, restraint and medication remained unchanged. Discussion and implications for practice RESPECT has the potential to change staff attitudes towards aggression in the short term. Further research is needed to investigate long‐term effects and impact on incidents of aggression

Occupational Risk due to Violence in a Psychiatric Ward

Occupational Risk due to Violence in a Psychiatric Ward: Silvana Salerno, et al. Division of Biomedicine, ENEA, ItalyObjectivesThis study aimed to elucidate causes of aggression from clinical records of a psychiatric ward of a major urban public hospital where aggression towards Health Care Workers [HCWs] was the second leading cause of hospital work‐related injuries after needlesticks.MethodsPsychiatric patients' clinical records for the period 2002–2005 were examined and coded. Data were analysed with the case‐control approach to identify the determinants of the aggressive behavior towards HCWs, after adjustment for age, gender, nationality and diagnosis of the patients.ResultsWe examined 2.196 records and identified 321 individuals who had become violent at least once towards nurses, pshysicians or other patients or relatives during their hospitalization. The victims of the aggressive behavior were mainly nurses. A history of involuntary admission was strongly associated with aggression [OR 4.5, 95% CI 3.4–5.9]. Diagnosis, gender and nationality of the patients were not predictive of aggressive behavior towards HCWs.ConclusionsInvoluntary admission to a psychiatric ward might be a cause of violent behavior towards health care workers, mainly nurses