Factors associated with aggressive behaviour in persons with cognitive impairments using home care services: A retrospective cross‐sectional study

Abstract

Aim This study aimed to investigate the frequency of documented aggression, on the part of cognitively impaired individuals, against health professionals in home care services and to highlight related factors. Design A retrospective cross‐sectional study was conducted using data obtained from the nursing documentation of six home care service organizations in Switzerland. Methods We analysed the nursing documentation of 1,186 clients in six home care services, between July 2019–September 2019, using the Cohen‐Mansfield Agitation Inventory. We conducted a factor analysis as well as a descriptive data analysis and logistic regression using IBM SPSS Statistics. Results A factor analysis revealed in five factors, of which three represented aggressive behaviour in the sample. These factors were physically aggressive behaviour, verbally aggressive behaviour and importunate behaviour. Aggressive incidents, documented in the nursing records of 14.7% of clients in our sample, tended to be associated with cognitive, communication and mobility difficulties. Impact statement This retrospective cross‐sectional survey gives an overview of the frequency and forms of documented aggressive behaviour on the part of persons with cognitive impairments towards health professionals in home care services. One of the motivating factors for this study was the awareness that aggressive behaviour on the part of clients may stress health professionals in various ways which in turn may have an impact on the quality of care provided. The study revealed that healthcare specialists, rather than more qualified general or psychiatric nurses, were routinely assigned to assisting such clients and therefore specific educational and training interventions for these specific group of staff are indicated.

Aggressive incidents in home care services and organizational support: A cross‐sectional survey in Switzerland

“…This result hints that unguided discussions between team colleagues might increase negative feelings against the care recipient. In the light the results of Schnelli, Ott et al ( 2021 ), which disclose that staff with lower education is mostly used in the case of clients with aggressive behaviour, these insights highlight the need for guided reflexive processes. Guided reflexive processes such as case reviews might help reframe the aggressive incidents experienced.…”

“…Investigations in the home care settings show that aggressive behaviour against professional caregivers occur often in the home care setting as well (Hanson et al, 2015 ; Schablon et al, 2018 ). Schnelli, Ott, et al ( 2021 ) found that 14.8% of clients availing home care services display verbally or physically aggressive behaviour towards caregivers and that such behaviours were linked to cognitive impairment. Home care services have gained importance due to demographic changes worldwide (Genet et al, 2012 ).…”

Facilitateurs et barrières à la pratique de la physiothérapie à domicile : une étude qualitative par focus group

“…Les soins à domicile doivent s'adapter et se développer pour répondre à ces différents changements. En Suisse, plusieurs études sur les soins infirmiers à domicile ont été menées (6)(7)(8)(9)(10)(11)(12) et d'autres recherches sont en cours. Les physiothérapeutes font partie des professionnels de santé qui interviennent au domicile des patients.…”

Development of a medication literacy assessment instrument (MELIA) for older people receiving home care

“…Several studies have shown that patients are often unaware of the necessity for their medication or unsure how to take their medication (Bailey et al, 2019 ; Schnelli et al, 2021 ). Therefore, systematic identification of people with limited or no ability to take responsibility for their medication therapy is critical (Gehring, 2015 ).…”

“…A structured and regular assessment of patients' medication literacy should be conducted to ensure that they are managing their medications appropriately (Bailey et al, 2019 ). This is especially relevant for the home care population, as patients usually suffer from several chronic diseases and 35% are cognitively impaired (Schnelli et al, 2021 ).…”