Health Care Workers' Experiences of Aggression.

PRIMARY OBJECTIVE: To identify the prevalence of patient aggression against health care workers, the consequences and coping mechanisms. DESIGN: Retrospective cross-sectional design. SUBJECTS: 50 participants comprised 37 nurses, 1 ward staff, 12 allied health staff employed in two brain injury wards with experience ranging from 3months to 34years. SETTING: Neurosciences and Brain Injury Rehabilitation wards of a metropolitan tertiary hospital in Brisbane. MAIN OUTCOME MEASURES: Researcher designed self-report questionnaire. RESULTS: 98% of respondents had experienced aggression during their health care careers with an average of 143.93 events. Physical injuries had been sustained by 40% of staff, psychological injury by 82%, but only 12% sought treatment. Verbal aggression related to receiving a psychological injury (r=0.305, p<0.05). Experiencing one type of aggression made it more likely the person would also experience the other types of aggression. Verbal aggression was correlated with physical aggression (r=0.429, p<0.01) and non-verbal aggression (r=0.286, p<0.05), and physical aggression was correlated with non-verbal aggression (r=0.333, p<0.05). The majority of staff used informal debriefing with others as their main coping strategy which was considered effective. CONCLUSIONS: Patient aggression is prevalent and of serious concern for staff working in hospital settings.

Prospective memory and frontal lobe function.

The study sought to examine the role of frontal lobe functioning in focal prospective memory (PM) performance and its relation to PM deficit in older adults. PM and working memory (WM) differences were studied in younger aged (n = 21), older aged (n = 20), and frontal injury (n = 14) groups. An event-based focal PM task was employed and three measures of WM were administered. The younger aged group differed from the other two groups in showing significantly higher scores on PM and on one of the WM measures, but there were no differences at a statistically significant level between the older aged group and the frontal injury groups on any of the memory measures. There were, however, some differences in correlations with a WM measure between groups. It is concluded that there are similarities and differences in the deficits in PM between older adults and patients with frontal lobe injury on focal as well as nonfocal PM tasks.

The correlates of aggression in people with acquired brain injury: a preliminary retrospective study.

PRIMARY OBJECTIVE: To identify correlates of aggressive behaviours in patients with acquired brain injury (ABI). METHODS AND PROCEDURES: During a 16 month period, patients who had ABI and who had been aggressive during hospitalization (n = 32) were identified by hospital staff. A comprehensive chart review of these patients was completed. Results were compared against results of a matched patient sample who had not been aggressive (32). MAIN OUTCOMES AND RESULTS: Five variables which were significantly correlated with aggression were entered into a standard logistic regression. The model explained 61.4% of the total variance and successfully predicted 87.5% of the non-aggressive group and 78.1% of the aggressive group. The overall correct prediction rate was 82.8%. Of the five variables, four were found to significantly contribute to the predictive ability of the model: an education of 10 years or less, a history of aggression, dependence on staff for assistance with activities of daily living and a hospitalization period of 51 days or more. CONCLUSIONS: The results highlight some variables related to aggression by patients with ABI in the hospital environment and can be utilized in staff education and training programmes to increase the awareness of risk factors.