Nurses' perceptions of patients with challenging behaviour in a psycho-geriatric setting

Abstract

The aim of the present research study was to establish and explore the nurses' perceptions of patients with challenging behaviour in a psycho-geriatric setting. These perceptions were additionally analyzed and found to differ by gender of participants. The data collected was both qualitative and quantitative in nature and was determined by means of a self-administered questionnaire. The items in the questionnaire were based on information collected during a review of literature pertaining to challenging behaviour. The instrument was piloted and then administered to a sample of thirty-six working in a psycho-geriatric setting. Thirty-one participated in the study. Findings of this study showed, that challenging behaviour was viewed by most nurses as an uncontrollable behaviour that may jeopardize the patient's or another person's physical safety in danger. Both the incidence and prevalence of such behaviour is high and nurses claimed that it was an everyday life experience. Elderly mentally ill patients offered challenges for various reasons such as cognitive dysfunction due to dementia, sensory problems, an unfamiliar environment and difficulty in describing their needs and fears. The nurses perceived their strength in being able to offer empathy to such patients but perceived a limitation in their ability to work as a team. As preventive and manageable methods, this study focused on training which would provide knowledge and skills to handle such behaviour in a professional and most appropriate manner. Good staffing levels, increased frequency of ward rounds and leisure activities within the psycho-geriatric setting were suggested as these helped the patient to feel better and to keep control of his behaviour. Another aspect which was revealed in this study is that nurses perceived needing protection and support from their colleagues and managers. As challenging behaviour is an everyday life event in the psycho-geriatric setting, providing nurses with support would help to reduce the level of stress. Striving to assist nurses to manage episodes of such behaviour is a challenge. Hence the need for research which investigates nurses perceptions of challenging behaviour in order to provide recommendations both for additional research and for improvements/changes in practice.