Aggression on haemodialysis units: a mixed method study

Julia Jones, Henk Nijman, Jamie Ross, Neil Ashman, Patrick Callaghan

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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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.

Original languageEnglish
Pages (from-to)180-93
Number of pages14
JournalJournal of Renal Care
Issue number3
Early online date16 Jul 2014
Publication statusPublished - 15 Aug 2014


  • Adult
  • Aggression
  • Attitude of Health Personnel
  • Cooperative Behavior
  • Cross-Sectional Studies
  • Female
  • Hemodialysis Units, Hospital
  • Humans
  • Interdisciplinary Communication
  • Interview, Psychological
  • Kidney Failure, Chronic
  • London
  • Male
  • 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


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