title: Physically violent behaviour in dementia care: Characteristics of residents and management of violent situations.
abstract: OBJECTIVE
  Physically violent behaviour (PVB) is common among residents with dementia and often complicates nursing care. This study aims to explore types of caring situations, resident characteristics related to PVB and professional caregivers' management of PVB.
  
  
  METHODS
  The study included 40 group homes for 309 residents with dementia. Data was gathered by means of structured interviews, the Multi-Dimensional Dementia Assessment Scale and the Geriatric Rating Scale.
  
  
  RESULTS
  Ninety-eight of the residents (31.7%) were assessed as showing PVB during the preceding week. Three factors were independently associated with PVB: male gender, antipsychotic treatment and decline in orientation. Violent residents were more likely to have impaired speech, difficulties understanding verbal communication and prescribed analgesics and antipsychotics than were non-violent residents. PVB occurred mainly in intimate helping situations and was managed by symptom-oriented approaches, such as distraction, medication and isolation. The working team also held frequent discussions about the residents with PVB.
  
  
  CONCLUSIONS
  This study shows that PVB is frequently displayed among residents in group homes for persons with dementia and the caregivers mainly manage PVB in a symptom-oriented way. To enhance the quality of care for patients with dementia, there is a need for interventions that aim to understand and manage the residents' physical violent behaviour.
authors.affiliation: Department of Nursing, Umeå University, The Caring Science Building, Umeå, Sweden. ulf.isaksson@nurs.umu.se
authors.forename: Ulf
authors.initials: U
authors.lastname: Isaksson
authors.forename: Ulla H
authors.initials: UH
authors.lastname: Graneheim
authors.forename: Sture
authors.initials: S
authors.lastname: Åström
authors.forename: Stig
authors.initials: S
authors.lastname: Karlsson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D016352:Group Homes / Q000458:organization & administration*; D006272:Health Facility Environment; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology*