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Herrera-Pino J, Benedetti-Isaac J, Ripoll-Córdoba D, Camargo L, Castillo-Tamara EE, Morales-Asencio B, Perea-Castro E, Torres Zambrano M, Ducassou A, Flórez Y, Porto MF, Gargiulo PA, Zurita-Cueva B, Caldichoury N, Coronado JC, Castellanos C, Ramírez-Penso C, López N. Effectiveness of deep brain stimulation on refractory aggression in pediatric patients with autism and severe intellectual disability: meta-analytic review. BMC Pediatr 2024; 24:487. [PMID: 39080575 PMCID: PMC11290060 DOI: 10.1186/s12887-024-04920-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Some patients with autism and severe intellectual disability may experience uncontrolled aggression, causing serious injury or harm to others, and the therapeutic ineffectiveness of traditional pharmacological and behavioral treatment may aggravate symptoms. Deep brain stimulation (DBS) has been tested in patients with little evidence in children and adolescents. Therefore, we analyzed the efficacy and safety of DBS in refractory aggression in pediatric subjects with autism (ASD) and severe intelligence deficit (ID).Methods A meta-analytic review of Web of Science (WOS) and Scopus articles, following Prisma criteria. A total of 555 articles were identified, but after applying the inclusion criteria, only 18 were analyzed. The review of the registries and the extraction of information was performed by 2 independent groups, to reduce the evaluator's bias. For the description of the results, pediatric patients with ASD or ID present in each registry, with an application of specialized scales (Overt aggression scale, OAS, and THE modified version of the OAS, MOAS) pre and post-DBS, with a clinical follow-up of at least 12 months, were considered valid. Clinical improvement was calculated using tests of aggressiveness. In each registry with available data and then pooling the means of all patients in the OAS and MOAS, the effect size of DBS (overall and per study) was estimated. Finally, the adapted NOS scale was applied to rate the studies' quality and level of bias.Results In the studies analyzed, 65/100 were pediatric patients, with a mean age of 16.8 years. Most of the studies were conducted in South America and Europe. In all teams, aggressive behavior was intractable, but only 9 groups (53/65) applied specialized scales to measure aggressiveness, and of these, only 51 subjects had a follow-up of at least 12 months. Thus, in 48/51 a clinical improvement of patients was estimated (94.2%), with a considerable overall effect size (OAS: d = 4.32; MOAS: d = 1.46). However, adverse effects and complications were found in 13/65 subjects undergoing DBS. The brain target with the most evidence and the fewest side effects was the posteromedial hypothalamic nuclei (pHypN). Finally, applying the adapted NOS scale, quality, and bias, only 9 studies show the best indicators.Conclusion An optimal level of efficacy was found in only half of the publications. This is mainly due to design errors and irrelevant information in the reports. We believe that DBS in intractable aggressiveness in children and adolescents with ASD and severe ID can be safe and effective if working groups apply rigorous criteria for patient selection, interdisciplinary assessments, objective scales for aggressiveness, and known surgical targets.
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Affiliation(s)
- Jorge Herrera-Pino
- College of Medicine, Florida International University, 11200 SW 8Th St, Miami, FL, 33199, USA
| | - Juancarlos Benedetti-Isaac
- Clinica Neurocardiovascular, Neurodinamia, Tv. 54 #21a-75, Cartagena, Colombia
- Misericordia International Clinic, Cra. 74 #76-105, Barranquilla, 080001, Colombia
| | - Daniela Ripoll-Córdoba
- Departamento de Ciencias Sociales, Universidad de La Costa, Cl. 58 #55 - 66, Barranquilla, 080002, Colombia
| | - Loida Camargo
- Facultad de Medicina, Universidad de Cartagena, Campus Zaragocilla, Cartagena de Indias, Bolívar, 130014, Colombia
| | - Edgard E Castillo-Tamara
- Facultad de Medicina, Universidad del Sinú, Provincia de Cartagena, Calle 30 #20-71, Cartagena de Indias, Bolívar, 130001, Colombia
| | - Breiner Morales-Asencio
- Departamento de Ciencias Sociales, Universidad de La Costa, Cl. 58 #55 - 66, Barranquilla, 080002, Colombia
| | - Esther Perea-Castro
- Clinica Neurocardiovascular, Neurodinamia, Tv. 54 #21a-75, Cartagena, Colombia
| | | | | | - Yuliana Flórez
- Departamento de Ciencias Sociales, Universidad de La Costa, Cl. 58 #55 - 66, Barranquilla, 080002, Colombia
| | - María F Porto
- Department of Cognition, Development and Educational Psychology, Universitat de Barcelona and Bellvitge Institute for Biomedical Research (IDIBELL), Carrer de La Feixa Llarga, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - Pascual A Gargiulo
- Laboratorio de Neurociencias y Psicología Experimental (CONICET), Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo. Parque General San Martín, Mendoza, M5502JMA, Argentina
| | - Boris Zurita-Cueva
- Departamento de Neurocirugía, Omni Hospital, Avenida abel Romeo Castillo y ave. Tanca Marengo., Guayaquil, 090513, Ecuador
| | - Nicole Caldichoury
- Departamento de Ciencias Sociales, Universidad de Los Lagos, Av Alberto-Hertha Fuchslocher 1305, Osorno, Los Lagos, Chile
| | - Juan-Carlos Coronado
- Facultad de Salud, Universidad Católica de Temuco, Montt 56, Temuco, Araucanía, 4780000, Chile
| | - Cesar Castellanos
- Instituto Dominicano para el Estudio de la Salud Integral y la Psicología Aplicada (IDESIP), C. Eugenio Deschamps No.5, Santo Domingo, 10014, República Dominicana
| | - Cleto Ramírez-Penso
- Departamento de Neurocirugía, Director general del Centro Cardio-Neuro-Oftalmológico y Trasplante (CECANOT), C/ Federico Velázquez #1, Sector Maria Auxiliadora, Santo Domingo, República Dominicana
- Sociedad Dominicana de Neurología y Neurocirugía (Pax- President), F38M+CHM, Santo Domingo, 10106, República Dominicana
| | - Norman López
- Departamento de Ciencias Sociales, Universidad de La Costa, Cl. 58 #55 - 66, Barranquilla, 080002, Colombia.
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Manuel Rodríguez 060, Temuco, 4790870, Chile.
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Hong S, Nam S, Wong JYH, Kim H. Post-traumatic responses to workplace violence among nursing professionals: a collaborative and comparative study in South Korea and Hong Kong. BMC Nurs 2023; 22:354. [PMID: 37794376 PMCID: PMC10548618 DOI: 10.1186/s12912-023-01502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Workplace violence has had a significant and negative psychological impact on nursing professionals worldwide. Concerted worldwide efforts to improve work environments have not yet removed nursing professionals from the threat of violence. It is highly essential to conduct comparative research in various working environments where the nurses of each country have unique experiences of workplace violence. The aim of this study was to examine the differences in the rate, associated factors, and post-traumatic responses to workplace violence between South Korean and Chinese nurses in Hong Kong among East Asian countries. METHODS A cross-sectional, correlational study design recruited a total of 471 registered nurses (319 South Korean nurses and 152 Chinese nurses in Hong Kong; overall response rate = 78.5%) at online communities in South Korea and Hong Kong. The data were collected by conducting a Qualtrics survey from January 15, 2020, to July 24, 2021. A structured questionnaire was administered for data collection, including rate of workplace violence, perception of workplace violence, attitudes toward workplace violence, coping styles, post-traumatic cognitions, post-traumatic stress disorder, post-traumatic growth, and mental health indicators (depression, anxiety, and stress). T-test, chi-squared, and binary logistic regression analyses were conducted. RESULTS In our sample, 30.7% South Korean nurses and 31.6% Chinese nurses in Hong Kong had experienced workplace violence. South Korean and Chinese nurses in Hong Kong with experience of workplace violence had lower perceptions of it. Nurses with experience of workplace violence reported lower levels of mental health, and this trend was more prominent among South Korean nurses. CONCLUSIONS Our study findings showed a positive association between workplace violence and post-traumatic responses in both settings. We found that the close monitoring of post-traumatic responses associated with workplace violence could be improved by enhancing nurses' perception of workplace violence.
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Affiliation(s)
- Soyun Hong
- College of Nursing Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
- Department of Nursing, Korean Bible University, Seoul, Republic of Korea
| | - Sujin Nam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China.
| | - Heejung Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
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Gong M, Yao L, Ge X, Liu Z, Zhang C, Yang Y, Amdanee N, Wang C, Zhang X. Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence. Front Psychiatry 2023; 14:1160357. [PMID: 37398588 PMCID: PMC10308378 DOI: 10.3389/fpsyt.2023.1160357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To explore the pattern of empathy characteristics in male patients with schizophrenia (SCH) and to examine whether empathy deficit is associated with impulsivity and premeditated violence. Methods One hundred and fourteen male SCH patients were enrolled in this study. The demographic data of all patients were collected and the subjects were divided into two groups, namely, the violent group, including 60 cases, and the non-violent group, comprising 54 cases, according to the Modified Overt Aggression Scale (MOAS). The Chinese version of the Interpersonal Reactivity Index-C (IRI-C) was used to evaluate empathy and the Impulsive/Predicted Aggression Scales (IPAS) was employed to assess the characteristics of aggression. Results Among the 60 patients in the violent group, 44 patients had impulsive aggression (IA) and 16 patients had premeditated aggression (PM) according to the IPAS scale. In the violent group, the scores of the four subfactors of the IRI-C, i.e., perspective taking (PT), fantasy (FS), personal distress (PD), and empathy concern (EC), were significantly lower than in the non-violent group. Stepwise logistic regression showed that PM was independent influencing factor for violent behaviors in SCH patients. Correlation analysis revealed that EC of affective empathy was positively correlated with PM but not with IA. Conclusion SCH patients with violent behavior had more extensive empathy deficits compared with non-violent SCH patients. EC, IA and PM are independent risk factors of violence in SCH patients. Empathy concern is an important index to predict PM in male patients with SCH.
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Affiliation(s)
- Muxin Gong
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
| | - Lei Yao
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaodan Ge
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zhenru Liu
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
| | - Caiyi Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yujing Yang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengdong Wang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiangrong Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Yu T, Pei W, Xu C, Zhang X, Deng C. Prediction of violence in male schizophrenia using sMRI, based on machine learning algorithms. BMC Psychiatry 2022; 22:676. [PMID: 36320010 PMCID: PMC9628088 DOI: 10.1186/s12888-022-04331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Violent behavior in patients with schizophrenia (SCZ) is a major social problem. The early identification of SCZ patients with violence can facilitate implementation of targeted intervention. METHODS A total of 57 male SCZ patients were recruited into this study. The general linear model was utilized to compare differences in structural magnetic resonance imaging (sMRI) including gray matter volume, cortical surface area, and cortical thickness between 30 SCZ patients who had exhibited violence and 27 SCZ patients without a history of violence. Based on machine learning algorithms, the different sMRI features between groups were integrated into the models for prediction of violence in SCZ patients. RESULTS After controlling for the whole brain volume and age, the general linear model showed significant reductions in right bankssts thickness, inferior parietal thickness as well as left frontal pole volume in the patients with SCZ and violence relative to those without violence. Among seven machine learning algorithms, Support Vector Machine (SVM) have better performance in differentiating patients with violence from those without violence, with its balanced accuracy and area under curve (AUC) reaching 0.8231 and 0.841, respectively. CONCLUSIONS Patients with SCZ who had a history of violence displayed reduced cortical thickness and volume in several brain regions. Based on machine learning algorithms, structural MRI features are useful to improve predictive ability of SCZ patients at particular risk of violence.
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Affiliation(s)
- Tao Yu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Wenzhi Pei
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Chunyuan Xu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Xulai Zhang
- Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People's Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022, Anhui, China.
| | - Chenchen Deng
- Anhui Province Maternity & Child Health Hospital, Hefei, 230022, Anhui, China.
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Välimäki M, Lam J, Bressington D, Cheung T, Wong WK, Cheng PYI, Ng CF, Ng T, Yam CP, Ip G, Paul L, Lantta T. Nurses', patients', and informal caregivers' attitudes toward aggression in psychiatric hospitals: A comparative survey study. PLoS One 2022; 17:e0274536. [PMID: 36174064 PMCID: PMC9522285 DOI: 10.1371/journal.pone.0274536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
Attitudes toward aggression is a controversial phenomenon in psychiatry. This study examined and compared attitudes toward patient aggression in psychiatric hospitals from the perspectives of nurses, patients and informal caregivers and identified factors associated to these attitudes. A total of 2,424 participants completed a self-reported instrument regarding attitudes toward aggression (12-items Perception of Aggression Scale; POAS-S). We analysed data from nurses (n = 782), patients (n = 886), and informal caregivers (n = 765). Pearson's r correlations were used to examine associations between variables. Differences between group scores were analysed using ANOVA/MANOVA with post-hoc Sheffe tests. Multivariate logistic regression models and logistic regression analysis were used to examine the effects of respondents' characteristics on their attitudes toward aggression. Nurses had significantly more negative and less tolerant perceptions toward aggression (mean [SD] 47.1 [7.5], p<0.001) than the patients (mean [SD] 44.4 [8.2]) and the informal caregivers (mean [SD] 45.0 [6.9), according to the POAS-S total scores. The same trend was found with the dysfunction and function sub-scores (mean [SD] 25.3 [4.1] and 15.0 [3.6], respectively); the differences between the groups were statistically significant (p <0.001) when nurses' scores were compared to those of both the patients (mean [SD] 23.7 [5.3] and 14.0 [4.1], respectively) and the informal caregivers (mean [SD] 24.4 [4.2] and 13.9 [3.5], respectively). The study offers new understanding of aggressive behavior in different treatment settings where attitudes toward patient behavior raises ethical and practical dilemmas. These results indicate a need for more targeted on-the-job training for nursing staff, aggression management rehabilitation programs for patients, and peer-support programs for informal caregivers focused on patient aggression.
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Affiliation(s)
- Maritta Välimäki
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Joyce Lam
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Daniel Bressington
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Wai Kit Wong
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Po Yee Ivy Cheng
- Community Psychiatric Services, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong (SAR), China
| | - Chi Fai Ng
- Department of Psychiatry, Tai Po Hospital, Tai Po, Hong Kong (SAR), China
| | - Tony Ng
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong (SAR), China
| | - Chun Pong Yam
- Department of Psychiatry, Kowloon Hospital, Kowloon, Hong Kong (SAR), China
| | - Glendy Ip
- Central Nursing Division, Kwai Chung Hospital, Kwai Chung, Hong Kong (SAR), China
- Hong Kong College of Mental Health Nursing, The Hong Kong Academy of Nursing, Hong Kong (SAR), China
| | - Lee Paul
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
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Nam S, Hong S, Kim H, Wong JYH, Fong DYT. Reliability and validity of the Korean 12-item Perception of Aggression Scale. J Psychiatr Ment Health Nurs 2022; 29:442-450. [PMID: 33780587 DOI: 10.1111/jpm.12759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/13/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The importance of and interest in nurses' attitudes towards and subjective experience with workplace violence in clinical settings is increasing. The prevalence of patient-perpetrated violence against Korean nurses in hospital settings is highly prevalent. Only few instruments are available to measure the nurses' perception of patient aggression in Korea. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to assess the linguistic and psychometric reliability and validity of an instrument that evaluates the attitude of Korean nursing staff towards patient-perpetrated workplace violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This valid and reliable instrument could be used to assess and monitor the nurses' attitudes towards aggressive tendencies in the workplace. The results could contribute to the development of relevant interventions for coping with violence by patients towards nursing staff and the implementation of practical training to cultivate healthy perceptions towards patients to foster therapeutic nurse-patient relationships. ABSTRACT: Introduction Despite the high prevalence of patient-perpetrated violence against Korean nurses globally, reliable and valid measures of patient aggression are lacking in Korean. Aim We translated the 12-item Perception of Aggression Scale (POAS) into Korean and psychometrically assessed its utility in measuring nurses' attitudes towards aggression. Methods The 12-item Korean POAS was obtained through forward-backward translation and cognitive debriefing. It was administered online to 319 nurses (mean age = 32.64 years; females = 96.2%), of which 206 completed it again after two weeks. Confirmatory factor analysis validated the 3-factor structure as hypothesized in the original version. The intra-class correlation coefficient was used to assess the test-retest reliability. Results The originally hypothesized 3-factor structure showed a good fit. The 3 dimensions: aggression as a dysfunctional or undesirable phenomenon, aggression as a functional or comprehensible phenomenon, and aggression as a protective measure had internal consistencies of 0.74, 0.86 and 0.90 and corresponding ICCs of 0.70, 0.86 and 0.90, respectively. Discussion The 12-item Korean POAS is a valid and reliable scale that might aid investigating nurses' attitudes towards patient aggression. Implications for practice The 12-item Korean POAS can help Korean nurses adopt protective behaviours and develop interventions to cope with aggression.
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Affiliation(s)
- Sujin Nam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Soyun Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Heejung Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Nielsen MB, Christensen JO, Hetland J, Finne LB. Organizational Prevention and Management Strategies for Workplace Aggression Among Child Protection Workers: A Project Protocol for the Oslo Workplace Aggression Survey (OWAS). Front Psychol 2020; 11:1401. [PMID: 32695050 PMCID: PMC7339981 DOI: 10.3389/fpsyg.2020.01401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
Background Previous research has established exposure to workplace aggression as a significant risk factor for employee functioning, well-being, and health. However, less is known about effective prevention and management strategies. The main objectives of the current project were to determine the impact of physical and psychological aggression on the well-being, health, and work ability of employees in the child welfare service and to establish whether a strong psychosocial safety climate and an ethical infrastructure are effective with regard to protecting employees against aggression. This project may help identify the specific risks child welfare workers are exposed to, the impact of workplace aggression on their health and well-being, and the most effective strategies to manage the problem. Furthermore, the findings should be central for developing laws and regulations and to any political decision on measures to tackle aggression in the workplace. Methods The study will employ two prospective data collections. Firstly, a three-wave longitudinal survey with a 6-month time lag between measurement points will be conducted among all 1,500 employees in the child welfare services in Oslo Municipality, Norway. Data will have a multilevel structure and will be linked to registry data on sickness absence. Secondly, a quantitative daily diary study over a 14-day period will include 150 of the respondents from the main survey study. The survey questionnaires mainly comprise well-established and psychometrically validated indicators of workplace aggression, health and well-being, psychosocial safety climate, ethical infrastructure, and other relevant factors. The Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) have approved this project (project no. 28496). Discussion This project will identify the impact of workplace aggression on child protection workers as well as provide information on how organizations can actively manage exposure to workplace aggression. The findings may serve as a starting point for intervention studies as well as the development of policies and guidelines on how to handle workplace aggression.
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Affiliation(s)
| | | | - Jørn Hetland
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Coccaro EF. The Overt Aggression Scale Modified (OAS-M) for clinical trials targeting impulsive aggression and intermittent explosive disorder: Validity, reliability, and correlates. J Psychiatr Res 2020; 124:50-57. [PMID: 32114032 DOI: 10.1016/j.jpsychires.2020.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/06/2020] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Abstract
While aggressive behavior is common, and a disorder of impulsive aggression has been defined in the DSM-5 (Intermittent Explosive Disorder: IED), there are no currently FDA approved interventions to reduce these behaviors. One obstacle to the development of interventions to treat aggression is the paucity of psychometrically valid measures to assess aggressive behavior in the context of clinical trials, especially those in the outpatients setting. While there are many assessment of trait aggression, very few attempt to assess current aggressive behavior over time and/or in individuals not in a closed setting. The Overt Aggression Scale Modified (OAS-M) was developed to fill this void and this paper reviews its development along with presenting new data on its validity, reliability, and correlates with related constructs. Overall, the OAS-M is a valid and reliable measure of state (e.g., week to week) aggression, has good psychometric properties, and shows evidence of change in clinical trials of agents with putative anti-aggressive efficacy.
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Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience and Psychotherapeutics Unit, Department of Psychiatry and Behavioral Health, The Ohio State University, Wexner College of Medicine, Columbus, OH, USA.
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Wong WK, Chien WT. Testing psychometric properties of a Chinese version of perception of aggression scale. Asian J Psychiatr 2017; 25:213-217. [PMID: 28262153 DOI: 10.1016/j.ajp.2016.10.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 10/14/2016] [Accepted: 10/29/2016] [Indexed: 10/20/2022]
Abstract
AIM This study was to evaluate the psychometric properties of the Chinese version of the 12-item Perception of Aggression Scale (POAS). METHOD It consists of three phases of testing, including (1) translation and back-translation and content validity; (2) semantic equivalence between translated Chinese and original English version; and (3) construct validity, internal consistency and test-retest reliability. RESULTS The translated Chinese and back-translated English version showed excellent similarities and agreements between two independent translators. The Chinese version indicated high item- and scale-level content validity indexes (0.86-1.00) and satisfactory semantic equivalence with the original English language version (weighted kappa=0.48-0.90; intraclass correlation coefficient=0.91). Exploratory factor analysis in 249 nursing students resulted in three components (dysfunctional, functional and protective dimensions), explaining 64% of the total variance, with satisfactory internal consistency (Cronbach's alpha=0.76-0.83) and good 2-week test-retest reliability (Pearson's r=0.87). The Chinese version of POAS was found to be a valid and reliable tool to examine nurses' attitudes towards patient aggression. DISCUSSION Chinese nurses in this study viewed patient aggression to be an undesirable negative behaviour suggestive of uncontrollability behaviour presented by the patient under their care.
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Affiliation(s)
- Wai Kit Wong
- School of Nursing, The Hong Kong Polytechnic University, A102, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- School of Nursing, The Hong Kong Polytechnic University, A102, Hung Hom, Hong Kong
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Abstract
This article is designed to provide an overview of the existing literature on pharmacologically managing aggression, with a specific focus on psychiatric diagnoses commonly associated with increased aggression. Self-injurious behaviors and suicide are sometimes classified as forms of aggression, but information presented here focuses primarily on aggression toward others (physical and/or verbal).
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Affiliation(s)
- William J Newman
- Division of Psychiatry and the Law, Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, 2230 Stockton Boulevard, 2nd Floor, Sacramento, CA 95817, USA.
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