title: The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.
abstract: BACKGROUND
  Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits.
  
  
  OBJECTIVE
  To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training.
  
  
  METHODS
  This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively.
  
  
  METHODS
  The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent.
  
  
  RESULTS
  Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams.
  
  
  CONCLUSIONS
  Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively within teams and thus contributed to the creation of low-conflict ward cultures.
authors.affiliation: CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Birgit
authors.initials: B
authors.lastname: Heckemann
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Graz, Austria.
authors.forename: Helga Elisabeth
authors.initials: HE
authors.lastname: Breimaier
authors.affiliation: Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Ruud J G
authors.initials: RJ
authors.lastname: Halfens
authors.affiliation: Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.|Department of Family Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
authors.affiliation: Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hahn
mesh_terms: D000374:Aggression; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D007407:Interviews as Topic; D009740:Nursing Staff / Q000193:education*; D036301:Qualitative Research; D013557:Switzerland
keywords: aggression; aggression management; healthcare; learning; nurses; qualitative descriptive content analysis; qualitative research; training