Volume 23, Issue 17-18 pp. 2542-2553
Original Article

Dealing with aggressive behaviour in nursing homes: caregivers’ use of recommended measures

Adelheid Zeller RN, MNS

Corresponding Author

Adelheid Zeller RN, MNS

Head of Bachelor Programme in Nursing

Department of Health, University of Applied Sciences St. Gallen, St. Gallen, Switzerland

Correspondence: Adelheid Zeller, Head of Bachelor Programme in Nursing, Department of Health, University of Applied Sciences St. Gallen, Rosenbergstrasse 59, CH-9000 St. Gallen, Switzerland. Telephone: +41 71 226 15 03.

E-mail:[email protected]

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Marianne Müller PhD

Marianne Müller PhD

Professor of Statistics

Institute of Data Analysis and Process Design, School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland

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Ian Needham PhD, RN

Ian Needham PhD, RN

Nursing Scientist

Psychiatric Services St. Gallen, Center of Education and Research, St. Gallen, Switzerland

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Theo Dassen PhD, RN

Theo Dassen PhD, RN

Head of Department of Nursing Science

Centre for the Humanities and Health Sciences, Charité-Universitätsmedizin Berlin, Berlin, Germany

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Gerjo Kok PhD

Gerjo Kok PhD

Professor Applied Psychology

Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands

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Ruud J G Halfens PhD, FEANS

Ruud J G Halfens PhD, FEANS

Associate Professor

Faculty of Health, Medicine and Life Sciences, Caphri, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

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First published: 26 December 2013
Citations: 8

Abstract

Aims and objectives

To identify groups of caregivers in terms of their use of measures for dealing with resident aggression and the differences between these groups related to their characteristics.

Background

Caregivers in nursing home are confronted with a major challenge when faced with the aggressive behaviour of residents. Therefore, the application of recommended measures is important in supporting caregivers and promoting safety for residents.

Design

Cross-sectional survey.

Methods

A total of 804 caregivers working in 21 Swiss nursing homes provided data. The questionnaire used was based on published recommendations regarding management of aggressive behaviour and amendments by experts.

Results

The most widely used measure aimed to calm down the resident and to understand the meaning of aggressive behaviour. Physical activities were applied by around 50% of the respondents, and interdisciplinary case reviews as well as standardised instruments for assessment and documentation were used by <50%. Caregiver characteristics such as employment level, support from superiors, institutionalised support for affected caregivers and training in aggression management are associated with their use of recommended measures. Furthermore, caregivers’ competence in empathising with the residents’ perspective in connection with their professional experience has a positive influence on applying recommended measures.

Conclusion

Caregivers use multifaceted measures in understanding the meaning of underlying aggression, but there is a certain failure to use standardised instruments. Caregivers differ significantly in the frequency of their application of recommended measures. Support from superiors and assistance for affected caregivers positively influence their use of measures, whereas training in aggression management leads to less use.

Relevance to clinical practice

Findings show the importance of support from superiors and institutionalised assistance for affected caregivers. Caregiver competence in empathising with the residents’ perspective is important in using person-centred approaches in the care of residents with aggressive behaviour.

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