The participants indicated that both patients and staff play important parts in causing and in intervening to prevent violence. This information can be used to help plan programs to prevent and intervene in aggressive behavior.
This article extends the work conducted by Fagan-Pryor, Femea, and Haber (1994), in which factor analyses were used to examine the congruence between aggressive behavior and type of intervention warranted (verbal, chemical, or physical), as rated by nursing personnel. The purpose of this study was to determine if 88 registered nurses (RNs) and 84 nursing assistants (NAs) would choose similar interventions for 84 aggressive behaviors. The three scales used (labeled Precursor, Defensive, and Acting Out) obtained Cronbach alpha internal consistency reliabilities ranging from .79 to .96. Analyses of variance indicated that RNs and NAs agreed on a set of precursor behaviors for which they would use therapeutic verbal intervention. RN and NA responses differed significantly only in prescribing the use of physical intervention for behaviors on the Defensive and Acting Out scales. In both situations, RNs selected fewer behaviors that required physical intervention than did NAs. Implications for clinical practice are presented.
In this pilot study, nursing staff matched three levels of intervention (verbal, chemical, and physical) with 84 aggressive behaviors. It was a preliminary step in the development of a theoretical framework regarding how nurses select interventions for aggressive patients. Specifically, it was an attempt to address the following: Do nurses intervene with aggressive behaviors based on learned stereotypes or do nurses perceive behavior as aggressive because there is consistency in the behavior and level of aggression? All 442 members of the nursing staff were invited to participate in the study; and 211 (48%) responded. Factor analyses were conducted on responses to the behaviors of subjects matched with each intervention. The same three factors were identified for verbal and chemical intervention: behaviors that are precursors to an actual aggressive episode, aggressive behaviors directed inwardly, and aggressive behaviors directed outwardly. The last two behaviors were also identified for physical intervention. The results suggest that the nursing staff did differentiate among behaviors reflecting differing levels of aggression and that they were not responding in a stereotypical manner.
The study's purpose was to report outcomes for 47 veterans who participated in a recovery-based psychiatric rehabilitation program. On the whole, these veterans had a history of long continuous hospital stays, ranging from 6 months to less than 45 years. The discharged veterans (15, 32%) experienced statistically greater community tenure (paired t (28) = -4.158, p < 0.0001, two-tailed) and decrease in number of admissions (pre M = 2.7; post M = 1.9) after participation. While community tenure and number of admissions remained the same for non-discharged veterans, increased positive staff-veteran interactions were reported by staff.
Many patients who receive antipsychotic medications experience dystonia, akinesia, dyskinesia, and akathisia, collectively called Extrapyramidal Symptom Side Effects (EPS). The purpose of this study was to establish interrater reliability for a Nursing EPS Assessment Scale developed to focus on all four symptom areas. Twenty RNs and 12 patients participated in the instrument development studies. After several revisions, interrater reliability significance was demonstrated at the 0.01 level. It was concluded that the Nursing EPS Assessment Scale possessed good interrater reliability for nursing assessment of EPS.
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