title: Attitudes toward patient aggression amongst mental health nurses in the 'zero tolerance' era: associations with burnout and length of experience.
abstract: UK government policy now officially encourages an attitude of 'zero tolerance' towards aggression against health care staff. This study examines levels of such tolerance amongst a group of mental health care staff and associations between tolerance and other occupational and stress factors. Thirty-seven staff completed a Tolerance Scale (from the Perceptions of Aggression Scale) and the Maslach Burnout Inventory. Tolerance for aggression was higher amongst more experienced staff (P < 0.01) and high tolerance was associated with low emotional exhaustion, low depersonalization and high personal accomplishment (P < 0.01). Some staff endorse positive statements about patient aggression and a tolerant attitude may be linked to low burnout. Nurse attitudes to patient aggression therefore are complex and do not necessarily equate with an approach of 'zero tolerance'.
authors.affiliation: Department of Nursing, University of Liverpool, Liverpool, UK. whitting@liv.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Whittington
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000374:Aggression / Q000523:psychology*; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D002983:Clinical Competence / Q000592:standards; D003152:Community Health Nursing; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D011568:Psychiatric Nursing; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors; D016526:Workload