The moderating effect of aggressive problem behaviors in the generation of more positive attitudes toward nursing home residents

Abstract

This study examined the ability of a social history intervention to generate more positive attitudes toward nursing home patients, and to increase staff members' perceived rewards of care-giving. In contrast to prior studies, residents' problem behaviors were examined as potential moderators in the relationship. Forty-three staff members participated in an experimental, 3 (informational condition: social history, medical, control) x 2 (time: pre-test, post-test) within-subjects factorial design that employed newly admitted residents as target patients. Findings showed that the social history intervention alone did not generate more positive attitudes toward patients or greater rewards of care-giving. Although a larger proportion of target patients manifested other problem behaviors with greater frequently, only aggressive problem behavior was associated with more negative attitudes toward patients. A post-hoc analysis revealed that after statistically controlling for the impact of patients' aggressive behavior, the social history information appeared to allow staff members to maintain more neutral attitudes toward patients. Considerations for the use of social history information in long-term care settings are addressed.

Hidden Workplace Violence

“…Often termed as ''problem behaviors,'' ''disruptive behaviors,'' or ''behavioral problems,'' these tags do not portray an objective characterization of aggression. 11,12 Nursing staff are already complacent about the relevance of reporting minor injuries or assault by patients with dementia. 4,9 The mismatch of classifications both minimizes and disguises the severity of patient-to-nurse workplace violence.…”

Behavioural symptoms of dementia in residential settings: A selective review of non-pharmacological interventions

“…However, these studies had three main methodological weaknesses: lack of control groups (Cohen-Mansfield et al, 1997;Hagen & Sayers, 1995); reliance on staff ratings rather than objective observations (Hagen & Sayers, 1995;Hillman et al, 2001;Moniz-Cook et al, 1998); and interventions with multiple components so it was not possible to identify which was effective (Opie et al, 2002;Proctor et al, 1999;Rovner et al, 1996). Hawthorne effects cannot be discounted as residential and nursing homes are often isolated places for staff to work (Sival, Albronda, Haffmans, Saltet & Schellekens, 2000), as noted in the Rowan Ward Report (Commission for Health Improvement, 2003).…”