title: The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature.
abstract: BACKGROUND
  Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce.
  
  
  OBJECTIVE
  To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research.
  
  
  METHODS
  Systematic, narrative review.
  
  
  METHODS
  Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion.
  
  
  METHODS
  The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated.
  
  
  RESULTS
  Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression.
  
  
  CONCLUSIONS
  Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level.
authors.affiliation: CAPHRI - School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands; GPCC-Gothenburg Centre for Person-centred Care, Sahlgrenska Academy, Gothenburg University, Centre for Person-Centred Care Research (GPCC), Gothenburg, Sweden. Electronic address: b.heckemann@maastrichtuniversity.nl.
authors.forename: B
authors.initials: B
authors.lastname: Heckemann
authors.affiliation: Department of Health Sciences, St. Gallen University of Applied Sciences, Rosenbergstrasse 59, Postfach, 9001 St. Gallen, Switzerland. Electronic address: heidi.zeller@fhsg.ch.
authors.forename: A
authors.initials: A
authors.lastname: Zeller
authors.affiliation: Berne University of Applied Sciences, Berner Fachhochschule, Fachbereich Gesundheit, Murtenstrasse 10, 3008 Bern, Switzerland. Electronic address: sabine.hahn@bfh.ch.
authors.forename: S
authors.initials: S
authors.lastname: Hahn
authors.affiliation: Center for the Humanities and Health Sciences, Department of Nursing Science, Charité-Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: theo.dassen@charite.de.
authors.forename: T
authors.initials: T
authors.lastname: Dassen
authors.affiliation: Department of Family Medicine and Department of Health Services Research, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: jos.schols@maastrichtuniversity.nl.
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: r.halfens@maastrichtuniversity.nl.
authors.forename: R J G
authors.initials: RJ
authors.lastname: Halfens
mesh_terms: D000374:Aggression / Q000523:psychology*; D006801:Humans; D007318:Inservice Training; D015402:Nursing Education Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011369:Professional-Patient Relations; D013338:Students, Nursing / Q000523:psychology*; D014754:Violence / Q000517:prevention & control; D017132:Workplace
keywords: Acute general hospital; Aggression; Review; Staff training; Staff–patient relationship; Violence