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

Abstract

Introduction. Occupational violence has been demonstrated to impact negatively on the wellbeing of nurses and patients. Staff attitudes towards causes and management of patients' aggression influences 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 longterm effects and impact on incidents of aggression.  Training programmes like RESPECT may be useful to improve attitudes towards causes of aggression and its management in LMIC hospitals. However, further evidence is required to demonstrate whether these results can be sustained over time and whether these attitudinal changes are associated with reduction of workplace violence.  Mental health nurses and other mental health professionals can play a key role in establishing hospital wide training and sharing skills across geographical boundaries

A scoping review of the impact of organisational factors on providers and related interventions in LMICs: Implications for respectful maternity care

“…Approaches to reduce workplace violence were focused on nurses, across multiple departments including maternity care. Education and/or training programs, risk assessment checklists and prevention protocols were some of the methods used to reduce workplace violence [94][95][96]. Nurses were trained in early identification and grading the risk of violence from patients and their families [94].…”

“…Nurses were trained in early identification and grading the risk of violence from patients and their families [94]. Capacity building resulted in positive attitudinal change among nurses to cope and respond to patient/family aggression [95,96]. The interventions did not focus on ways that managers can support providers and respond to escalating events.…”

Nurses’, patients’, and informal caregivers’ attitudes toward aggression in psychiatric hospitals: A comparative survey study

“…Nurses who had participated in all three levels of the training (Levels I–III) had still significantly less tolerant attitudes toward patients despite the general clinical assumption that education and training programs for staff reduce or eliminate patient aggressive behavior at work. Some previous studies have still shown that training could produce at least short-term positive improvements in nurses’ attitudes toward patient aggression [ 62 , 63 ]. However, a recent Cochrane review showed that the evidence is very uncertain about the short-term effects of education and training on aggression, while on the long run, education may not reduce aggression at all, compared to no intervention [ 64 ].…”

Attitudes of psychiatric nurses towards aggression: A polish study

“…Fewer factors in the Polish version of the ATAS mean that Polish psychiatric nurses presently see fewer options for responding to aggression than nurses in some other countries. As attitudes towards aggression influence how nurses interact with patients (Coneo et al, 2020), treatment for patients with mental illness will only improve if these attitudes change. Therefore, the current default behaviour of nurses must be transformed in order to improve patient care.…”

“…Attitudes towards aggression influence the relationship between nurses and patients (Coneo et al, 2020;Doedens et al, 2019;Laukkanen et al, 2019), and psychiatric nurses experience three times more violence from patients than other nursing specializations (Edward et al, 2014). This is important, because the more exposure to violence nursing personnel have, the more negative their attitudes tend to become (Bregar et al, 2018;Jalil et al, 2017;Renwick et al, 2019).…”