BACKGROUND: Aggression on haemodialysis units is a growing problem internationally that has received little research attention to date. Aggressive behaviour by patients or their relatives can compromise the safety and well-being of staff and other patients sharing a haemodialysis session.
OBJECTIVES: The objectives of the study were twofold: First, to identify the prevalance and nature of aggression on haemodialysis units; and second, to investigate factors that contribute to aggressive behaviour on haemodialysis units.
DESIGN AND METHODS: A cross-sectional, sequential mixed method research design was adopted, with two research methods utilised. Incidents of aggressive behaviour were recorded over a 12-month period, using a renal version of the Staff Observation Aggression Scale. Six months after the incident data collection had commenced, semi-structured qualitative interviews were conducted with 29 multidisciplinary members of staff.
RESULTS: Over 12 months, 74 aggressive incidents were recorded. The majority of incidents involved verbal aggression, and the perpetrators were a minority of patients, relatives and staff. Two patients were responsible for 38% of all incidents; both patients had mental health problems. Distinct temporal patterns to the aggressive behaviour were observed according to the day of the week and time of day.
CONCLUSION: This study demonstrates that aggression is a significant problem on haemodialysis units, with verbal aggression most prevalent. The temporal patterns to aggression observed are related to the uniqueness of the haemodialysis setting, with a distinctly different treatment environment compared with other healthcare settings.
- Attitude of Health Personnel
- Cooperative Behavior
- Cross-Sectional Studies
- Hemodialysis Units, Hospital
- Interdisciplinary Communication
- Interview, Psychological
- Kidney Failure, Chronic
- Mentally Ill Persons
- Middle Aged
- Nurse-Patient Relations
- Patient Satisfaction
- Professional-Family Relations
- Qualitative Research
- Renal Dialysis
- Safety Management
- Journal Article
- Research Support, Non-U.S. Gov't