REDUCING VIOLENCE AGAINST NURSING HOME CAREGIVERS

减少针对疗养院护理人员的暴力行为

• 批准号: 6088194
• 负责人: DONNA M GATES
• 金额: $ 17.57万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2002-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6088194
• 关键词: aggression; behavior modification; behavior therapy; behavioral /social science research tag; caregivers; clinical research; education evaluation /planning; human subject; injury prevention; nursing homes; occupational hazard; occupational stressor; patient care personnel relations; violence

Growing violence against health care workers prompted the Occupational Safety and Health Administration in 1996 to publish employer guidelines. Certified nursing assistants (CNAs) working in long term care represent the occupation most at risk of workplace assault. These caregivers receive minimal education regarding the care of some of the most challenging and aggressive patients. As the number of nursing home patients and CNAs increases in the near future, efforts are needed to improve the nursing home environment for both CNAs and residents. A preliminary study by the investigators found that CNAs, who daily experience verbal and physical violence, lack the knowledge and skills to prevent violence. The purpose of the is to use randomized, quasi-experimental methods to test the effectiveness of an intervention to decrease violence against CNAs. The aims of the study are to: 1) describe the context in which assaults occur, 2) increase CNAs' skills to prevent assaults, and 3) decrease the incidence of assaults against CNAs. The study design is quasi-experimental with three nursing homes serving as a control group and three homes as an intervention group. Within each nursing home 18 subjects will be randomly selected to participate in the three year study. The intervention, based on Social Cognitive Theory, will consist of three 2 hour in-services and six 1/2 hour problem solving groups. Subjects will be assessed for changes in their assault prevention skills prior to the intervention and upon completion of the intervention. The type and number of assaults will also be assessed before and after the intervention. Data analysis will describe the context of the assaults and test whether there was a significant difference in the number of violent incidents between the intervention group and the control group. Data analysis will also determine whether the intervention group demonstrated a significant difference in violence prevention skills than the control group.

针对医护人员的暴力行为日益增多，促使美国职业安全与健康管理局在1996年发布了雇主指南。在长期护理中工作的注册护士助理(CNA)是工作场所遭受攻击风险最大的职业。这些护理者接受关于护理一些最具挑战性和攻击性的患者的最低限度的教育。在不久的将来，随着养老院患者和社区护理机构数量的增加，需要努力改善社区护理机构和居民的养老院环境。调查人员的一项初步研究发现，每天遭受言语和身体暴力的CNA缺乏预防暴力的知识和技能。其目的是使用随机的准实验方法来测试干预措施的有效性，以减少对CNA的暴力行为。研究的目的是：1)描述攻击发生的背景，2)提高CNA预防攻击的技能，3)减少针对CNA的攻击的发生率。研究设计为准实验设计，三家养老院作为对照组，三家养老院作为干预组。在每个养老院中，将随机选择18名受试者参加为期三年的研究。干预以社会认知理论为基础，包括三个两小时的服务中小组和六个一个半小时的问题解决小组。在干预之前和干预结束后，将对受试者进行评估，以了解他们预防袭击的技能的变化。还将在干预前后对袭击的类型和次数进行评估。数据分析将描述袭击的背景，并测试干预组和对照组之间的暴力事件数量是否存在显着差异。数据分析还将确定干预组在暴力预防技能方面是否与对照组有显著差异。