AGGRESSIVE BEHAVIOUR OF PATIENTS AND RELATIONS AND HOW IT AFFECTS NURSING CARE PERFORMANCE IN HEALTH CARE FACILITIES IN AKOKO SOUTH WEST LOCAL GOVERNMENT AREA, ONDO STATE

CHARPTER   ONE

1.0                                      INTRODUCTION

1.1     Background of the Study

Workplace aggression is a prevalent problem in clinical medical practice and the consequences may be considerable. It is a major professional and health workforce policy concern, in terms of occupational health and safety, and the potential impact on care quality, safety and access(Hills & Joyce 2014).SwainGale &Greenwood(2014) indicated that working in a healthcare environment is a known risk factor for violence since patients’aggression towards staff is often present in a hospitalsetting but the extent, type and variation among various occupations and roles are not known.

Aggression is overt, often harmful, social interaction with the intention of inflicting damage or other unpleasantness upon another individual. It is a virtually universal behaviour among animals. It may occur either in retaliation or without provocation. In humans, frustration due to blocked goals can cause aggression. Submissiveness may be viewed as the opposite of aggressiveness.

In definitions commonly employed in the social sciences and behavioural sciences, aggression is a response by an individual that delivers something unpleasant to another person (Anderson, 2004). Some definitions include that the individual must intend to harm another person. Predatory or defensive behaviour between members of different species may not be considered aggression in the same sense (Akert 2010).

Aggression and violence is increasing in hospital settings. It has become a significant problem in health care professions. Not only as the number of incident increased but also the severity of the impact has caused profound traumatic effects on the primary, secondary and tertiary victims. Most health care professional than ever are suffering from symptoms of post-traumatic stress disorder and this also has caused great problem in quality and efficient health care delivery to patients in Nigeria as a country.

Williams (2004) indicated that aggressive and violence behaviour is caused by patient and relations. Violence is experienced by nurses influence job satisfaction, job performance and quality of patient care; more over it causes psychological harm to victims.Davidson (2005) stated that psychological and emotional impact of violence especially in nurses result into inefficient and inability to render quality care to patient. Aggressive and violent behaviour that is directed at nursing staff by patient and their relatives is a huge problem.Rippon (2004) describes how the number of violent incidents has increased along with the severity of those incidents and suggests that this may reflect the general increase in violence in the society. Statistics show that nurses working in accident and emergency department are most likely to face violence and aggressive outburst (Health and Safety Commission Advisory Committee, 2007).Rippon (2004) cited the work of Speilberger and Sydman  (1994). Who   point     out how anger, aggression and hostility are used interchangeably.

Beale and Daniel (2006) offer a definition of work related violence, incidents where staff are abused, threatened or assaulted in related to their work.  Involving an explicit or implicit challenge to their safety, well- being or health.Aggression occasionally causes people to alter their pattern of action, response, and resistance (Benerd, 2009). This is normal and natural as far as human beings are concerned. It’s as old as the world itself and varies from one person to another and it is found among men and women, young and old. Herbert, (2003) indicated that women are more submissive, less   aggressive in their feeling and more easily hurt, but with men, the reverse is the case they are more aggressive and irritable, and this can result in violence.

According to Bernard and Wathson(2009), Aggression therefore could be termed as an instinct which causes people to act in a way resulting to a provoked attack on other person in relation to a change. In most cases aggressive attitude alter a positive behaviour to a negative one because of the fact that the individual may fail to recognise the situation of things at that particular time. People that lack perseverance, optimism, endurance, respect and those who are self-centred are prone to aggression.

Aggressive attitude or behaviour can be passive or active. It’s passive aggression, when an individual feels uncomfortable about making a clear statement of his or her feelings, therefore that individual now uses devious and unclear method to express anger in this case, the real issue is suppressed. On the other hand, active aggression is said to be direct manoeuvre to control another person but in such case, the issue becomes violent (Fagbenro, 2009).The statistics released by united State Department of Justice, (2007) shown that more than 90,000 people have aggression due to one reason or the other. The life threatening situation in which patient present in the hospital may predispose patient and relations being aggressive since aggression cannot be totally eradicated in hospital environment, it can at least be minimised, if appropriate measures are put in place to alleviate patients and their relations anxiety.

In a hospital setting, where a Doctor is not immediately around and yet his attention is needed the patients and relation may become aggressive and inpatient. This can easily be taken care of by the nurse by utilizing his/her communication skills appropriately. It means, that communication is a very important tool in minimising aggression in nursing department and for this reason; all should be thoroughly versed in communication skills (Wathson, 2006).Some individual tend to react to the aggressive attitude of these patients by being aggressive in response. This type of situation is not conducive for giving the type of intervention that is required in the nursing department. The nurses being givers of health care in such an explosive atmosphere should endeavour to imbibe all the qualities of good nurses and be extra patience even in the face of extreme provocation having understood the concept of behaviour in health illnesses.

1.2    STATEMENT OF PROBLEM

Osadolor, (2007) observed that a greater number of nurses have been injured while battling with the aggressive response of patient and relatives. Olubunmi (2011) in his own study found that there is a higher rate of illness or diseases complications among patients with aggression. This therefore drew the attention of the researcher to find out responsible factors for patient/ relations aggression towards nurses in emergency situations.

1.3    RESEARCH QUESTIONS

The following research questions will guide the conduct of the study.

1)    What are the causes of aggressive behaviour of patients and relations that come to nurses in emergency in all health care facilities units in akoko south west local govt area of Ondo State?

2)    What are the measures taken to control aggressive behaviour in the Hospital?

3)    What impact does the aggressive behaviour of patients and relations have on nursing care performance?

1.4    OBJECTIVES

The objectives for this study are to:

1)     Identify the causes of aggression against nurses by the patients and their relations.

2)     Identify measures used to handle such aggressive behaviours exhibited by patients and their relations.

3)     Know the impact of the aggressive behaviour exhibited by patient and their relation on the performance of nursing care.

1.5    SIGNIFICANCE OF THE STUDY

This is to help nurses to be aware that most aggressive behavior of  patient and relation is due to delay in intervention, when the patients visit the health care facility and they were delayed unnecessary, definitely they will be aggressive.

•    This Study also help the nurses to know their actions and reactions that can lead to patients aggressive behaviors and how to precautionary measure to prevent it.

•    It helps the nurses to understand the negative impacts of the patient’s aggressive behavior on the efficient of health care services given to the patient and how to handle such behavior in order to promote healthy interpersonal relationship between the nurses and the patients.

•    This study could serve as a basis for further research work in promoting the efficiency of services rendered in the field of Nursing.

1.6    DEFINITION OF TERMS

AGGRESSIVE BEHAVIOUR- This is violent or hostile feeling or behaviour expressed as a reaction about a situation

PATIENT – A person receiving medical treatment under medical personnel.

RELATION – people who follow their sick person to the hospital.

NURSING CARE PERFORMANCE: these are the cares given to patients by nurses in the course of their duties.

Anger: Anger is defined as a strong uncomfortable emotional response to provocation that is unwanted and incongruent with one’s values, beliefs or rights.

Aggression: Aggression refers to behaviour that is intended to cause harm or pain. Aggression can be either physical or verbal.

1.7    LIMITATION OF STUDY

    During the course of caring out this study, the researcher will be faced with the following problems:

-    Time factor, the period in which the study will be carried out will not be enough because of other activities.

-    Distance will be another barrier, transportation from one place to the other for the success of the research work may not be too easy.

-    Finance, this will also affect the study because money will be needed in typing and binding the project.

-    Lack of cooperation from the respondents

PLEASE, print the following instructions and information if you will like to order/buy our complete written material(s).

HOW TO RECEIVE PROJECT MATERIAL(S)

After paying the appropriate amount (#3000) into our bank Account below, send the following information to our Whatsapp 08061135915 OR bavicola13@gmail.com, edupedia17@gmail.com :

(1) Your project topics

(2)  Email Address

(3)  Payment Name

(4) Teller Number

We will send the DOWNLOAD LINK for your material(s) immediately we receive bank alert

BANK ACCOUNTS

Account Name: Bakare Victor Oladapo
Access Bank         0759882072
First Bank            3077844205
Skye Bank            3023641985
GT Bank               0262146570

HOW TO IDENTIFY SCAM/FRAUD

As a result of fraud in Nigeria, people don’t believe there are good online businesses in Nigeria.

But on this site, we have provided “chapter one” of all our project topics and materials in order to convince you that we have the complete materials.

Secondly, we have provided our Bank Account on this site. Our Bank Account contains all information about the owner of this website. For your own security, all payment should be made in the bank.

No Fraudulent company uses Bank Account as a means of payment, because Bank Account contains the overall information of the owner.

CAUTION/WARNING

Please, DO NOT COPY any of our materials on this website WORD-TO-WORD. These materials are to assist, direct you during your project.  Study the materials carefully and use the information in them to develop your own new copy. Copying these materials word-to-word is CHEATING/ ILLEGAL because it affects Educational standard, and we will not be held responsible for it. If you must copy word-to-word please do not order/buy.

That you ordered this material shows you have agreed not to copy word-to-word.