Nurses’ educational needs when dealing with aggression from patients and their families: a mixed-methods study

OBJECTIVES: To explore the type of education needed for nurses when dealing with aggression from patients and their families. DESIGN: A two-phase sequential mixed-methods study. SETTING: This study was conducted in Japan, with phase I from March to November 2016 and phase II in November 2018. MAIN OUTCOME MEASURES: The challenges faced by nurses when dealing with incidents of aggression from the neutral perspective of neither nurse nor patient/family and perceptions of the educational contents developed in this study. Descriptive analyses were used to examine the data retrieved from both phases. PARTICIPANTS: Phase I entailed semistructured interviews among 11 neutral-party participants who observed aggressive incidents between nurses and patients/families. Phase II consisted of a web survey conducted among 102 nursing students and 308 nursing professionals. RESULTS: Phase I resulted in the identification of the following five main educational components: understanding the mechanisms of anger and aggression, maintaining self-awareness, observant listening, managing the self-impression, and communicating based on specific disease characteristics. Each component was related to improved communication through self-awareness. The results of phase II indicated that participants positively perceived these educational contents as likely to be effective for dealing with aggression from patients/families. CONCLUSIONS: This study clarified the type of education needed for nurses when dealing with aggression based on multiple viewpoints. Specifically, neutral-party interviews revealed that communication should be improved through self-awareness. A subsequent survey among nurses and nursing students showed that the identified educational contents were positively received.