A cross-sectional, descriptive survey of nurses' attitudes towards patient violence and management strategies in Hong Kong accident and emergency departments

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A cross-sectional, descriptive survey of nurses' attitudes towards patient violence and management strategies in Hong Kong accident and emergency departments

 

Author: Cheung, Kai-yeung
Title: A cross-sectional, descriptive survey of nurses' attitudes towards patient violence and management strategies in Hong Kong accident and emergency departments
Degree: M.Sc.
Year: 2012
Subject: Nurses -- China -- Hong Kong -- Attitudes.
Emergency nursing -- China -- Hong Kong.
Violence in hospitals -- China -- Hong Kong.
Hospitals -- Emergency services -- China -- Hong Kong -- Management.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: 104 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2509219
URI: http://theses.lib.polyu.edu.hk/handle/200/6531
Abstract: Aim: This dissertation reports a study examining attitudes of nursing staff towards patient violence and its management strategies in Hong Kong Accident & Emergency (A&E) departments. Background: There is a growing interest in nurses' attitudes towards patient violence in healthcare settings. However, in Hong Kong, little research has been carried out with regards to A&E nurses' perspectives and the relationship between patient violence and nurses' personal and occupational characteristics remains uncertain. Method: A convenience sample of 123 nurses working in 4 public A&E departments in Hong Kong were surveyed about their attitudes towards patient violence and its management strategies using the Management of Aggression and Violence Attitude Scale (MAVAS) developed by Duxbury (2002). The psychometric properties of the MAVAS were also evaluated to determine its reliability and validity to be used in Hong Kong's emergency care settings. Exploratory factor analysis and varimax factor rotation were used to refine the factor structure of the MAVAS. Results: Psychometric evaluation of the MAVAS showed that the MAVAS had good content validity and test-retest reliability. The refined 4-factors solution explained a total of 43.4% variance. It addressed 4 different domains of nurses' attitudes towards patient violence, including, "Importance of communication with patients", "Perceived effectiveness of interventions", "Pitfalls of interventions" and "Perceived need for intervention". The overall internal consistency (Cronbach's alpha) of the refined scale was 0.79 and ranged from 0.40 to 0.77 across the 4 subscales. Statistically significant differences were found across study hospitals in the 2 subscales' mean scores, "Importance of communication with patients" and "Perceived effectiveness of interventions". There were neither statistically significant differences nor relationships between the mean scores of the MAVAS subscales and the gender groups, job positions, educational levels, working experience, assault frequency, and the frequency of using various management strategies in patient violence of the A&E nurses' respondents. From the open-ended questions, respondents viewed "Lengthy waiting time," "Patients with mental health presentation" and "Patient is under the influence of alcohol" as the major contributory factors in patient violence. Conclusion: Patient violence is a significant issue in the A&E departments of Hong Kong. Organizational factors such as policies and practices may play a role in influencing A&E nurses' attitudes towards this issue. Despite preliminary evidence on its psychometric properties established in this study, further psychometric testing of the MAVAS is recommended to establish its robustness before it can be recommended for wider use in the A&E setting.

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