title: Workplace aggression experienced by frontline staff in dementia care.
abstract: OBJECTIVE
  To describe the frequency of aggressive acts experienced by frontline staff working in two models of dementia care: Residential Alzheimer's Care Centers and Secured Dementia Units and to explore the associations between aggressive acts experienced by frontline staff and factors related to the work context and care providers.
  
  
  BACKGROUND
  Aggression towards healthcare providers in residential long-term care settings is well documented. However, few studies have examined associations between aggressive behaviours towards care providers and organisational factors.
  
  
  METHODS
  A cross-sectional survey.
  
  
  METHODS
  The survey included demographic items and questions about aggressive acts experienced by staff and contextual factors. Analyses included: (1) descriptive statistics, (2) tests of difference (i.e. Student's t-test, Mann-Whitney U-test, chi-squared test and anova), (3) bivariate associations (i.e. Pearson and Spearman rank order correlations) and (4) multivariate linear regression.
  
  
  RESULTS
  Ninety-one health care aides and licensed practical nurses working in four nursing units using two models of dementia care participated (response rate 81%). The most frequently reported types of aggression were physical assault (50% of staff, n = 45) and emotional abuse (48% of staff, n = 44). Aggressive acts were significantly associated with working in Secured Dementia Units rather than Residential Alzheimer's Care Centers.
  
  
  CONCLUSIONS
  Frontline staff working in Secured Dementia Units were exposed to higher frequencies of various types of aggressive acts mainly initiated by residents. Future research needs to explore modifiable workplace factors associated with aggressive acts in a larger sample across a variety of long-term care settings.
  
  
  CONCLUSIONS
  To prevent staff perceived aggressive acts, leaders and managers in dementia care need to acknowledge the complex topic of workplace aggression and encourage an open discussion among frontline staff without assigning blame. Care provider strategies for dealing with aggressive behaviour have to be implemented in policies and clinical practice.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Department of Geriatric Medicine, Danderyd Hospital, Danderyd, Sweden. anne-marie.bostrom@ki.se
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Boström
authors.forename: Janet E
authors.initials: JE
authors.lastname: Squires
authors.forename: Agnes
authors.initials: A
authors.lastname: Mitchell
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sales
authors.forename: Carole A
authors.initials: CA
authors.lastname: Estabrooks
mesh_terms: D000374:Aggression; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D006801:Humans; D017132:Workplace