Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury

Abstract

The ABC method is a behaviour management technique for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. In this longitudinal intervention study with double baseline measurements we evaluated the effectiveness of the ABC method in patients with behavioural problems after acquired brain injury. Fifty-six patients participated in this study. Outcome was measured in terms of overall neuropsychiatric problem behaviour, aggression, apathy and emotional burden experienced by nurses. A process evaluation was performed to investigate usability and acceptability of the method and identify factors that influenced effectiveness. Friedman's ANOVA showed a small significant reduction over time in overall neuropsychiatric problem behaviour and aggression. The reduction was most prominent between the first baseline measurement and the post-implementation and follow-up measurements, not between the second baseline measurement and the post-implementation or followup measurements. This first group study on the effects of the ABC method could not prove this technique is effective for patients with behavioural problems after acquired brain injury. Nurses indicated that the ABC method was not fully implemented in their daily routines. This may have influenced results and makes it yet premature to draw firm conclusions on the effects of the ABC method.

Safe and Supportive Neurorehabilitation Environments: Results of a Structured Observation of Physical Features Across Two Rehabilitation Facilities

“…Beyond necessary compliance to safety regulations and standards in hospital building design and construction, safety management comprises components of occupational health and safety such as infection control, manual handling, and reducing risk of injury. Safety management for both staff and patients in a neurotrauma facility, similar to psychiatric settings, must also incorporate appropriate management of patient neurobehavioral symptoms such as agitation, physical and verbal aggression, irritability, and confusion as a result of the original brain trauma (Williamson et al, 2019; Winkins et al, 2017). A recent systematic review found that agitation occurs in up to 41% of brain injury patients in acute care settings and up to 70% of patients in rehabilitation settings.…”

Dealing with Patients with Behavioural Problems After Acquired Brain Injury: Nurses’ Experiences with the Antecedent Behaviour Consequence Method

“…In addition, patients staying at the departments at the time of the measurements and fulfilled the inclusion criteria (non-progressive ABI, for example traumatic brain injury or stroke, according to medical records, ≥18 years of age, sufficient command of language (by clinical judgement), no post-traumatic amnesia, no decreased consciousness during assessment and giving approval for participation) (Winkens et al, 2019) were included.…”

“…This study is part of the long-term follow-up (LT-FU) of our longitudinal group intervention study. The primary goal of our group intervention study was to measure the effect of the ABC method on the behavioural problems of ABI patients (Winkens et al, 2019). A trend was shown towards a decrease of the patients' behavioural problems, albeit not significant.…”

“…Furthermore, in this process the nursing staff obtain more knowledge about behavioural problems and their triggers, including the impact of their own behaviour, due to the training and working with the ABC method. A more extensive description of the ABC method can be found in Winkens et al (2019).…”

Process evaluation of the implementation of the ABC method, an intervention for nurses dealing with challenging behaviour of patients with brain injury

“…Based on this analysis, a patient- and situation-tailored intervention is made to reduce challenging behaviour. A more extensive description of the ABC method can be found in Winkens et al [ 10 ].…”