Using Delphi method to address factors contributing to aggressive behaviour in mental health settings

IF 2.6 4区医学 Q1 NURSING

Journal of Psychiatric and Mental Health Nursing Pub Date : 2024-03-26 DOI:10.1111/jpm.13049

Rasha Eweida, Nashwa Ibrahim

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引用次数: 0

Abstract

What Is Known about the Subject?

Nurses' perspectives and consensus on the possible key factors contributing to aggression at inpatient units can be summarized into patients' related factors, staff related factors and environment related factors.
Results of the possible factors contributing to aggression at inpatient units reflect the complicated nature of this problem.

What the Paper Adds to Existing Knowledge

Perspectives of nurses as frontline mental health professionals on factors contributing to aggression as one of the psychiatric emergencies were considered through an iterative process. This approach gave nurses an opportunity to revisit their own views in each round to provide an in-depth reflection in the light of the contribution of others.

What Are the Implications for Mental Health Nursing Practice?

Nursing curricula should focus on nurses' communication skills and emotion regulation training.
An open dialogue between nurses and people with mental health issues should be initiated to discuss the possible key factors contributing to aggressive behaviour at inpatient units from both standpoints.
Mental health nurses' turnover at inpatient settings could be targeted through the design and implementation of aggression prevention protocols

4.1 Introduction

Aggression at inpatient units is a universal problem leading to hazardous outcomes.

4.2 Aim

To generate group consensus about factors contributing to aggressive behaviour among patients with mental health issues at inpatient units.

4.3 Methods

Nurses working at inpatient psychiatric departments were approached, and purposive sampling was employed to implement Delphi technique. A total of three Delphi rounds were conducted online. The average percent of majority opinions method was followed to measure consensus in which questions with a cut-off rate below 69.7% were included in the next round.

4.4 Results

Twenty-one nurse experts with different skills participated in this study. Consensus increased among nurse experts across rounds for the following items: Patients' misinterpretation of the attitude of the healthcare providers, severity of mental health issues, attitude and communication style of the healthcare providers, nurses limited emotional regulation capacity and the inadequate staff–patient ratio in psychiatric wards.

4.5 Discussion

The complicated nature of aggressive behaviour displayed by people with mental health issues is reflected on the results of the current study; patients' related factors, staff related factors and environment related factors constitute interacting facets for this issue.

4.6 Implications for Mental Health Nurses

Nurse scientists could use insights derived from this study to design studies aiming at assessment and management of aggression at inpatient units guided by implementation science frameworks. Additionally, open dialogues between nurses and people with mental health issues could be initiated about factors contributing to aggression at inpatient units. Mental health nursing training should focus on nurses' communication and emotion regulation skills.

查看原文本刊更多论文

使用德尔菲法解决心理健康环境中导致攻击行为的因素。

对该主题的了解：护士们对可能导致住院部攻击行为的关键因素的看法和共识可归纳为与患者相关的因素、与工作人员相关的因素和与环境相关的因素。对造成住院部侵犯行为的可能因素的研究结果反映了这一问题的复杂性。论文对现有知识的补充：作为一线精神卫生专业人员，护士们对导致作为精神科急症之一的攻击行为的因素的看法是通过反复过程来考虑的。这种方法让护士们有机会在每一轮讨论中重新审视自己的观点，并根据他人的意见进行深入反思。这对心理健康护理实践有何意义？护理课程应注重护士的沟通技巧和情绪调节训练。应在护士和精神疾病患者之间开展公开对话，从双方的角度讨论可能导致住院患者攻击行为的关键因素。可以通过设计和实施预防攻击行为的规程来解决住院环境中精神健康护士的流失问题 ABSTRACT: Introduction 在住院部发生攻击行为是一个普遍问题，会导致危险的后果。目的就导致住院部精神疾病患者攻击行为的因素达成共识。方法接触在精神科住院部工作的护士，采用目的性抽样法实施德尔菲技术。共进行了三轮德尔菲在线讨论。采用多数意见的平均百分比法来衡量共识，其中截断率低于 69.7% 的问题被纳入下一轮。结果 21 名具有不同技能的护士专家参与了本研究。在不同轮次中，护士专家就以下项目达成的共识有所增加：患者对医护人员态度的误解、精神健康问题的严重程度、医护人员的态度和沟通方式、护士情绪调节能力有限以及精神科病房的医护人员与患者比例不足。讨论本研究结果反映了精神疾病患者攻击行为的复杂性，患者相关因素、医护人员相关因素和环境相关因素构成了这一问题的交互影响因素。对心理健康护士的启示护士科学家可以利用从本研究中获得的启示，在实施科学框架的指导下，设计旨在评估和管理住院部攻击行为的研究。此外，护士和有心理健康问题的人之间可以就导致住院部攻击行为的因素展开公开对话。心理健康护理培训应注重护士的沟通和情绪调节技能。

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来源期刊

Journal of Psychiatric and Mental Health Nursing 医学-护理

CiteScore

4.70

自引率

3.70%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Psychiatric and Mental Health Nursing is an international journal which publishes research and scholarly papers that advance the development of policy, practice, research and education in all aspects of mental health nursing. We publish rigorously conducted research, literature reviews, essays and debates, and consumer practitioner narratives; all of which add new knowledge and advance practice globally. All papers must have clear implications for mental health nursing either solely or part of multidisciplinary practice. Papers are welcomed which draw on single or multiple research and academic disciplines. We give space to practitioner and consumer perspectives and ensure research published in the journal can be understood by a wide audience. We encourage critical debate and exchange of ideas and therefore welcome letters to the editor and essays and debates in mental health.