Ervaringen van hulpverleners met agressie van opgenomen (forensisch) psychiatrische patiënten.

Abstract

Abstract Introduction Up till now, the clinical experience of 24-hour care workers in handling and preventing aggression has not been used and studied in a systematic way. In this study the experiences of workers with aggression, and their knowledge about the prevention of aggression, was mapped in a structured manner. The impact that aggression has on psychiatric caregivers was also investigated. Aim Unlocking the experience and knowledge of psychiatric workers, working with patients whose risk of aggressive behavior is relatively high. Which interventions are judged to be effective in preventing aggression by psychiatric caregivers themselves? And: what is the 'impact' on these caregivers due to (repeated) confrontation with aggressive patients? Method A quantitative survey study was conducted in which two questionnaires were used. The first questionnaire was specially designed for this study and contained a list of interventions that might be helpful to prevent aggression, which had to be rated according to their assumed effectiveness. The second questionnaire was a Dutch translation of the Impact of Aggression on Carers Scale (IMPACS; Needham et al, 2005). The questionnaires were deployed in three psychiatric inpatient departments of the division Altrecht Aventurijn in Den Dolder. Results The survey was sent to 210 psychiatric caregivers, of which 85 returned the questionnaires (40.5%). Making individual crisis intervention plans, was judged to be the most effective preventive intervention by the respondents. The strongest negative consequences of aggression appeared to be experiencing a disturbance in the relationship with the patient as a result of aggression, as was measured with the IMPACS. Furthermore, the study indicated that university graduates (n = 13) had the highest IMPACS scores, followed by HBO-educated (n = 54) and MBO-educated [n = 16, F (2, 80) = 3.7. p = 0.03].

Conclusion Making individual crisis intervention plans was judged to be the most effective preventive intervention, according to the respondents. In clinical day-to-day practice, however, these so-called crisis intervention plans tend to be ‘forgotten’, or at least not used properly. The educational background of the workers was the only staff characteristic that was associated with the IMPACS scores.