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Ian Needham

Publications and source records attributed to Ian Needham.

4 recordsLinked to original sources
PubMed2005

Non-somatic effects of patient aggression on nurses: a systematic review.

AIM: This paper describes a systematic review of the predominant non-somatic effects of patient assault on nurses. Background. Patient aggression towards nurses is a longstanding problem in most nursing domains. Although reports on the consequences of physical aggression are more numerous, the non-physical effects create much suffering. METHOD: A systematic review of literature from 1983 to May 2003 was conducted using the Medline, CINAHL, PsychINFO and PSYINDEX databases. Articles from international journals in English or German and reporting at least three non-somatic responses to patient aggression were included. FINDINGS: The electronic search produced 6616 articles. After application of the inclusion and exclusion criteria, 25 texts from eight countries and four domains of nursing remained. Twenty-eight main effects were found, and these were categorized using a system suggested by Lanza and including bio-physiological, emotional, cognitive, and social dimensions. The predominant responses were anger, fear or anxiety, post-traumatic stress disorder symptoms, guilt, self-blame, and shame. These main effects occurred across most countries and nursing domains. CONCLUSION: Despite differing countries, cultures, research designs and settings, nurses' responses to patient aggression are similar. Standardized questionnaires could help improve estimations of the real prevalence of non-somatic effects. Given the suffering caused by non-somatic effects, research should be aimed at preventing patient aggression and at developing better ways to prepare nurses to cope with this problem.

Aggression↗
PubMed2002

Coercive procedures and facilities in Swiss psychiatry.

BACKGROUND: Coercive measures in psychiatry,although in many cases effective in violence management and injury reduction, have been criticised from a consumerist point of view. METHOD: A questionnaire regarding coercive facilities and procedures was dispatched to the charge nurses of 86 acute psychiatric admission wards in German speaking Switzerland covering a catchment area of 75% of the Swiss population. RESULTS: 95% of all wards responded rendering the survey representative. The majority of wards have seclusion rooms and 55% of charge nurses perceive seclusion facilities as adequate. Two to twenty staff members are involved in overwhelming dangerous patients and some discontent is expressed at the haphazard fashion in which such events occur. Almost 70% of the wards use a form for reporting, 42 % of wards keep statistics on violent incidents and 17% of wards have access to these data. Of all wards 84% register injections against patients' will, 83% seclusion, and 78% mechanical restraint and a minority of wards register the coercive administration of oral medication, forced nutrition, threats of coercive measures in case of pharmacological non-compliance. DISCUSSION: Isolation, the coercive administration of medicine and restraint techniques are sensitive forms of treatment. Deficits reported by the charge nurses point to the need for enhanced facilities and improved forms of coercion management such as training in the use of mechanical restraints and the overwhelming of dangerous patients. CONCLUSION: The data show considerable differences in the facilities, the use, and the recording of coercive measures in the area under scrutiny.

Adult↗