Duperouzel Helen
Calderstones NHS Trust, UK.
J Intellect Disabil. 2008 Dec;12(4):295-307. doi: 10.1177/1744629508100495.
Ward managers working in a medium secure learning disability service were asked to identify members of staff who they believed to be superior in the management of violent and aggressive individuals. A grounded theory approach was used to interview staff about their management of imminent aggression. The participants explained their strategies in terms of the following eight themes, which were common to all interviews: safety and de-escalation, attribution and control, relationships, understanding and empowerment, anticipating reactions, creating a façade, communication, and humour. The participants described the importance of building up trusting relationships with clients when trying to understand the reasons for the client's behaviour. They also explained how they offer a ;get-out clause' to the client, a way for the client to decide to calm down without losing face. The participants also reported that creating the appearance of being in control can help, as does the use of humour to aid communication.
在中等安全级别的学习障碍服务机构工作的病房管理人员被要求找出他们认为在管理暴力和攻击性患者方面表现出色的工作人员。采用扎根理论方法就工作人员对即将发生的攻击行为的管理进行访谈。参与者从以下八个主题阐述了他们的策略，这些主题在所有访谈中都很常见：安全与平息、归因与控制、关系、理解与赋权、预测反应、营造表象、沟通和幽默。参与者描述了在试图理解患者行为原因时与患者建立信任关系的重要性。他们还解释了如何为患者提供一个“脱身之计”，即让患者能够不失面子地决定冷静下来的方式。参与者还报告说，营造掌控局面的表象会有所帮助，运用幽默辅助沟通也有同样效果。
