Resistance to Care: contributing factors and associated behaviours in healthcare facilities.

AIMS This article reports results of a study of contributing factors and associated behaviours in specific clinical areas to resistance to care episodes. BACKGROUND Resistance to Care has previously been studied in aged care settings, and previous studies have reported patient behaviours and appropriate responses. Resistance to Care is a defensive response by patients towards healthcare staff and is demonstrated in various non-compliant behaviours. DESIGN Cross-sectional study. METHODS A cross-sectional survey of a representative sample of nurses (n = 5044), who were members of the New South Wales Nurses' Association in Australia, was conducted in 2008-2009. RESULTS Resistance to Care episodes occur in various clinical settings and may be precipitated by a range of clinical diagnoses and symptoms. They may also be triggered during various nursing activities that nurses recognize as high-risk for these episodes. CONCLUSION The reported Resistance to Care behaviours are similar to those reported in studies of aggression and violence; however, they require a substantially different response by nurses in various clinical contexts.

[1]  M. Guest,et al.  Organizational risk management of resistance to care episodes in health facilities. , 2012, Journal of advanced nursing.

[2]  R Smith,et al.  Using Video Simulated Presence to reduce resistance to care and increase participation of adults with dementia , 2011, American journal of Alzheimer's disease and other dementias.

[3]  R. Jablonski,et al.  An intervention to reduce care-resistant behavior in persons with dementia during oral hygiene: a pilot study. , 2011, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[4]  Byron Gajewski,et al.  Elderspeak Communication: Impact on Dementia Care , 2009, American journal of Alzheimer's disease and other dementias.

[5]  M. Hazelton,et al.  An overview of swearing and its impact on mental health nursing practice. , 2008, International journal of mental health nursing.

[6]  B. I. Van der Heijden,et al.  Violence risks in nursing--results from the European 'NEXT' Study. , 2008, Occupational medicine.

[7]  W. Cross,et al.  Occupational violence and assault in mental health nursing: a scoping project for a Victorian Mental Health Service. , 2008, International journal of mental health nursing.

[8]  S. Luther,et al.  Agitation and resistiveness to care are two separate behavioral syndromes of dementia. , 2007, Journal of the American Medical Directors Association.

[9]  Susan Phillips,et al.  Countering Workplace Aggression: An Urban Tertiary Care Institutional Exemplar , 2007, Nursing administration quarterly.

[10]  Carla P Rennie,et al.  Advances in injury severity scoring. , 2007, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[11]  K. Williams,et al.  A Case Study of Resistiveness to Care and Elderspeak , 2007, Research and Theory for Nursing Practice.

[12]  G. Farrell,et al.  Scoping workplace aggression in nursing: findings from an Australian study. , 2006, Journal of advanced nursing.

[13]  E. Buikstra,et al.  Workplace violence in Queensland, Australia: the results of a comparative study. , 2006, International journal of nursing practice.

[14]  D. Ryan,et al.  Aggression and violence - a problem in Irish Accident and Emergency departments? , 2006, Journal of nursing management.

[15]  J. Fischer,et al.  The Impact of Patient Aggression on Carers Scale: instrument derivation and psychometric testing. , 2005, Scandinavian journal of caring sciences.

[16]  T. Church,et al.  An epidemiological study of the magnitude and consequences of work related violence: the Minnesota Nurses’ Study , 2004, Occupational and Environmental Medicine.

[17]  B. Mullan,et al.  Aggressive and violent incidents: perceptions of training and support among staff caring for older people and people with head injury. , 2004, Journal of clinical nursing.

[18]  D. Hegney,et al.  Workplace violence in nursing in Queensland, Australia: a self-reported study. , 2003, International journal of nursing practice.

[19]  N. Tabak,et al.  Interventions used by nursing staff members with psychogeriatric patients resisting care. , 2002, International journal of nursing studies.

[20]  Sandra A Quintal.  Violence against psychiatric nurses. An untreated epidemic? , 2002, Journal of psychosocial nursing and mental health services.

[21]  M. Segatore,et al.  Managing delirium and agitation in elderly hospitalized orthopaedic patients: Part 2--Interventions. , 2001, Orthopedic nursing.

[22]  M. Segatore,et al.  Managing delirium and agitation in elderly hospitalized orthopaedic patients: Part I--Theoretical aspects. , 2001, Orthopedic nursing.

[23]  B. Robinson,et al.  Cognitive predictors of resistiveness in dementia patients. , 1999, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[24]  A. Hurley,et al.  Development and testing of the Resistiveness to Care Scale. , 1999, Research in nursing & health.

[25]  S. Misner,et al.  Insights of nurses about assault in hospital-based emergency departments. , 1998, Image--the journal of nursing scholarship.

[26]  M. Gibson.  Differentiating aggressive and resistive behaviors in long-term care. , 1997, Journal of gerontological nursing.

[27]  E. Poster.  A multinational study of psychiatric nursing staffs' beliefs and concerns about work safety and patient assault. , 1996, Archives of psychiatric nursing.

[28]  M. Kaas,et al.  Resistance to care. , 1996, Journal of gerontological nursing.

[29]  D. Knopman,et al.  A Descriptive Study of Physically Aggressive Behavior in Dementia by Direct Observation , 1994, Journal of the American Geriatrics Society.

[30]  L. Volicer,et al.  A single-case-study method for treating resistiveness in patients with Alzheimer's disease. , 1992, Hospital & community psychiatry.

[31]  B. Chang,et al.  Agitation in the demented patient. A framework for management. , 1991, Journal of gerontological nursing.

[32]  J. Endicott,et al.  The Overt Aggression Scale for the objective rating of verbal and physical aggression. , 1986, The American journal of psychiatry.

[33]  M. Lanza.  The reactions of nursing staff to physical assault by a patient. , 1983, Hospital & community psychiatry.