Department of Applied Research & Development in Nursing, Bern University of Applied Sciences, Bern, Switzerland.
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
J Adv Nurs. 2017 Dec;73(12):3050-3060. doi: 10.1111/jan.13366. Epub 2017 Jul 16.
AIM(S): To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals.
Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored.
A qualitative descriptive study underpinned by the Reasoned Action Approach.
METHOD(S): Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis.
We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments".
CONCLUSION(S): Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff.
探索综合医院护士管理人员在预防和管理患者和访客攻击行为方面的行为、态度、感知的社会规范和行为控制。
综合医院的患者和访客攻击行为是一个全球性问题，给人类带来了巨大的痛苦和组织成本。管理人员是创造低攻击环境的关键人物，但他们在减少患者和访客攻击行为方面的角色和行为仍未得到探索。
基于理性行为理论的定性描述性研究。
2015 年 10 月至 2016 年 1 月，我们在瑞士对护理领导者进行了五次焦点小组和 13 次个人访谈。半结构式访谈和焦点小组被记录、转录，并在定性内容分析中进行了分析。
我们确定了三个主要主题：（一）背景因素：“通过不同的视角看待患者和访客的攻击行为”；（二）决定因素和意图：“良好的意图与严峻的组织现实相竞争”；（三）行为：“预防和管理攻击行为，不懈努力创造低攻击工作环境”。
由于缺乏有效的沟通、组织反馈回路、将攻击事件的情境和组织管理联系起来的协议和程序，护士管理人员在处理患者和访客攻击行为方面存在困难。此外，由于财政资源匮乏和缺乏兴趣，护士管理人员在组织层面上处理攻击行为是一项重大挑战。将患者和访客攻击行为视为一个商业案例可能会提高组织的意识和兴趣。此外，明确沟通期望、需求和资源可以优化对员工的支持提供。
