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Researchers explored nurses' attitudes toward clinical aggression in medical-surgical units before and after an education program. Findings indicated a shift after the intervention toward participants agreeing with attitudinal statements on several factors. Future research is recommended related to impact on practice.
Aggression and violence in the workplace are recognized internationally as major issues for many healthcare organizations and their employees (Beattie, Griffiths, Innes, & Morphet, 2019). Aggression and violence expressed by patients may be the result of frustration, fear, or anxiety about their care, and may or may not be associated with mental illness (Design Council, 2014). Common clinical settings for aggression are mental health, emergency departments (ED), aged care (Phillips, 2016), and medical-surgical units (Sato, Yumoto, & Fukahori, 2016). Clinical aggression is defined as "aggression within the clinical interaction between clinician or health professional and patient" (Knott, Gerdtz, Daniel, Dearie, & Holsheimer, 2017, p. 4). Managing clinical aggression in health services is important to provide a therapeutic environment for patients, families, and visitors, and a safe workplace for staff (Morphet et al., 2014). Staff awareness of patients' particular needs and requirements can affect a positive interaction when caring for patients with clinical aggression (Farrell, Shafiei, & Chan, 2014).
Literature Review
The search engine Google Scholar and electronic databases Ovid Medline, Embase, ProQuest, and CINAHL were searched for 2014-2018 using keywords clinical aggression, violence, attitudes, nurse, medical, surgical, and wards. Relevant review and primary research articles in English language and available in full text were selected by title and abstract.
Two systematic reviews of the literature were identified. A review and meta-analysis by Edward and colleagues (2015) included factors relating to aggression against nurses by patients, their relatives, or other staff. The study of 14 papers found all clinical nurses are at risk for clinical aggression; however, physical abuse is more common for mental health nurses than those in other settings, and more common for males. In the same study, data were dichotomized during analysis to categorize mental health and nonmental health nurses, and identify effect of work context. Edward and co-authors found mental health nurses have three times the odds of physical assault from patients, relatives, or staff compared to nurses working in other settings, which is likely to impact staff recruitment and...