Inpatient Aggression and Nursing - Research Paper

Introduction

In the medical industry, depression cases are a burning issue, and it happens that nurses suffer most of their effects. In most cases, nurses working in psychiatric words are hit the hardest, and this is because there is a high prevalence of aggression among the mentally ill. The high prevalence of aggression in such patients is a function of the psychopathology of their ailments, patient-nurse relationship, the atmosphere in the psychiatric wards, the patient's age and aggression history as well as the approach given to these patients by the medical fraternity (Tomagova, Borikova, Lepiesova & Cap, 2016). These cases are characterized by episodes of physical and non-physical violence against nurses. For instance, mentally ill patients lodge physical war against nurses through kicks as well as unpleasant utterances (Elder, Evans & Nizette, 2011). In this case, PICOT's pertinence aims at establishing the experiences and attitudes of nurses regarding aggressive behavior among mentally ill patients as they seek to help them in the wards.

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Research Question

Aggression among mentally ill patients is a multidisciplinary issue as it touches on various aspects. However, it narrows down to the identification of aggression's prevalence among the mentally ill, and the consequential attitudes by nurses towards such patients. This happens so because nurses, in one way or another, must respond to the aggressive behavior from patents (Monsen, 2018). An extension of this revolves around the identification of factors triggering this aggressive behavior as well as the management techniques that can be used to manage the aggression effectively. The last bit of the question touches on the differences between nurses, and in this perspective, there is an examination or nurses' training and how the training is designed to manage aggressive behaviors. Typically, PICOT is a structured mechanism of defining research questions, as demonstrated below (Monsen, 2018).

The Problem

The problem in this study is aggression. However, it is the mother of other problems materializing from its occurrence. For instance, the rate of aggression is not a subject to underrate, and thus, how it affects nurses discharging medical services to the aggressive patients are also other problems (Tomagova et al., 2016). For instance, the issue of physical attacks on nurses by aggressive patients is one of the fundamental problems to be addressed. Likewise, the state or rather, the condition of the nurses who are exposed to aggressive patients is also key. To this end, their experiences as they work in such environments is a significant issue. Again, their attitudes, as well as an approach towards aggressive patents, also counts. Therefore, aggression becomes the most fundamental problem in this study. However, it touches and creates other problems such as poor patient-nurse relationship (Elder, Evans & Nizette, 2011). Thus, the question to ask in this line is, "what is the state of affairs regarding aggression among mentally ill patients and how it affects nurses discharging medical services to them?"

Intervention

In this step, the question seeks to find out the management strategies that could probably deal with aggressive behaviors among mentally ill patients. The development of interventions to the problem at hand aims at improving the quality of nursing services in psychiatric wards (Monsen, 2018). Consider a situation where there is a poor patient-nurse relationship characterized by unpleasant utterances as well as physical violence. To this end, training nurses and allowing some of them to specialize in the management of aggressive patients, especially mentally is a significant move (Tomagova et al., 2016). Again, probable analysis of the nurses' perceptions regarding aggressive patients is also paramount. This is because there are differences in perception, and this amounts to different approaches and treatment of aggressive patients by nurses. In this part, the subject of attitude comes in, and in most cases, most nurses develop and wear negative attitudes, in an offensive, intrusive and destructive manner, towards the aggressive patients (Tomagova et al., 2016). This calls for the development of measures aiming at taming this attitude. Thus, the question to ask in this part is, "what is the most effective way of down stepping aggression among mentally ill patients as well as the negative attitude towards them by nurses?"

Comparison

The comparison section of PICOT explores to establish an alternative to the intervention mechanisms available. In this study, one of the significant issues that could have an effective alternative touch on the training of nurses. Even though training nurses on strategic mechanisms of handling aggressive patients, medical facilities should also embrace the use of psychopharmacological medications in pursuit of mentally stable patients (Tomagova et al., 2016). The essence of carrying out comparisons of various alternatives is that it enables the researcher to establish mechanisms of interventions to be prioritized as well as substitutes that can equally work should they fail (Roussel, & Thomas, 2016). Again, it also helps in the identification of strategies that can be used hand in hand in the management of aggression among the mentally ill as well as the negative attitude channeled to them by nurses. Lastly, it also reveals the limitations and shortcomings of the study (Tomagova et al., 2016). In this part, the question to answer is, "what is the best approach to aggression among mentally ill patients, and what are the probable alternatives?"

Outcome

A whopping 98.58% of nurses discharging medical services in psychiatric words suffer the effects of aggression among the patients they handle (Tomagova et al., 2016). The most common form of aggression was the verbal form. However, nurses also posted results that split them into two distinct groups, and the difference was that there were diverse perceptions regarding the mentally ill patients between nurses who underwent through educational training aiming at managing aggressive behaviors among patients (Tomagova et al., 2016). The question answerable in this perspective is, "what is the situation like regarding patient aggression as well as experiences and attitudes?"

Time

The amount of time used or rather, allocated for the study comes to light in this part (Roussel & Thomas, 2016). However, in this perspective, the time factor is a tool unearthing various issues related to the problem. For instance, its length is crucial in the documentation of the incidences of physical attacks on nurses by aggressive patients (Tomagova et al., 2016). Again, it also explains the timeframes within which most of the attacks, or rather, evidence of aggression was noted.

Conclusion

Aggression is an inevitable problem among mentally ill patients in hospitals. Likewise, the attitude and approach given to them by nurses are also imminent. Therefore, a PICOT is necessary to examine the situation as it is by studying patient-nurse relationship as well as how the aggression among patients affect nurses.

References

Elder, R., Evans, K., & Nizette, D. (2011). Psychiatric & Mental Health Nursing - E-Book. Mosby Australia, 2011. Retrieved from https://books.google.co.ke/books?id=acnpcImuEtYC&pg=PA414&dq=aggression+among+mentally+ill,+and+how+it+affect+nurses&hl=en&sa=X&ved=0ahUKEwjZkcXb2pDhAhUT5uAKHSFOBIgQ6AEIOjAD#v=onepage&q=aggression%20among%20mentally%20ill%2C%20and%20how%20it%20affect%20nurses&f=false

Monsen, K. A. (2018). Intervention effectiveness research: Quality improvement and program evaluation. Cham, Switzerland: Springer, [2018]. Retrieved from https://books.google.co.ke/books?id=9do1DwAAQBAJ&pg=PA26&dq=intervention+in+picot&hl=en&sa=X&ved=0ahUKEwjq4vql5ZDhAhW3AWMBHd3xDBsQ6AEIKDAA#v=onepage&q=intervention%20in%20picot&f=false

Roussel, L. A., & Thomas, T. (2016). Initiating and Sustaining the Clinical Nurse Leader Role. Jones & Bartlett Learning. Retrieved from https://books.google.co.ke/books?id=LWEhCl-RAsoC&pg=PA137&dq=SIGNIFICANCE+OF+time+in+PICOT&hl=en&sa=X&ved=0ahUKEwi64tHs75DhAhUMkxQKHZbqA20Q6AEINTAC#v=onepage&q=SIGNIFICANCE%20OF%20time%20in%20PICOT&f=false

Tomagova, M., Borikova, I., Lepiesova, M., & Cap, J. (2016). Nurses' Experience and Attitudes Towards Inpatient Aggression on Psychiatric Wards. Central European Journal of Nursing and Midwifery, 7(3), 461-469. Retrieved from http://periodika.osu.cz/cejnm/dok/2016-03/16-tomagova-et-al.pdf