B Heckemann1, A Zeller2, S Hahn3, T Dassen4, J M G A Schols5, R J G Halfens6. 1. CAPHRI - School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands; GPCC-Gothenburg Centre for Person-centred Care, Sahlgrenska Academy, Gothenburg University, Centre for Person-Centred Care Research (GPCC), Gothenburg, Sweden. Electronic address: b.heckemann@maastrichtuniversity.nl. 2. Department of Health Sciences, St. Gallen University of Applied Sciences, Rosenbergstrasse 59, Postfach, 9001 St. Gallen, Switzerland. Electronic address: heidi.zeller@fhsg.ch. 3. Berne University of Applied Sciences, Berner Fachhochschule, Fachbereich Gesundheit, Murtenstrasse 10, 3008 Bern, Switzerland. Electronic address: sabine.hahn@bfh.ch. 4. Center for the Humanities and Health Sciences, Department of Nursing Science, Charité-Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: theo.dassen@charite.de. 5. Department of Family Medicine and Department of Health Services Research, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: jos.schols@maastrichtuniversity.nl. 6. Faculty of Health, Medicine and Life Sciences, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: r.halfens@maastrichtuniversity.nl.
Abstract
BACKGROUND: Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS: To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN: Systematic, narrative review. DATA SOURCES: Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS: The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS: Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. CONCLUSION: Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level.
BACKGROUND:Patientaggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS: To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN: Systematic, narrative review. DATA SOURCES: Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS: The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS: Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patientaggression. CONCLUSION: Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level.
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