Effectiveness of a training course (RESPECT) on attitudes about causes/management of aggression in Northern Uganda

Abstract

Background:One of the main hazards within health care practice comes from occupational violence; this is even more salient in certain countries of sub-Saharan Africa, as there is a lack governmental policies and procedures to guarantee health and safety standards. This study aims to evaluate the impact of a 4-day aggression management training (RESPECT) on staff’s attitudes regarding management and causes of aggressive episodes in the Gulu Regional Referral Hospital (GRRH), Uganda. Methods:This was a quasi-experimental pre-test and post-test study. Sample (N=97) was composed by employees of the GRRH taking part in the 4-day RESPECT training. Attitudes were measured with the Management of Aggression and Violence Attitude Scale (MAVAS). Findings:Participants showed greater agreement with environmental or external factors as main cause of patient aggression at post-test (Z=-4.18, p<0.001). Perceptions about the effectiveness of non-physical methods showed significant changes after the training (Z=-3.19, p=001). Likewise, it was observed a significant change on responses to the item ‘It is difficult to prevent patients from becoming aggressive’, with participants showing less agreement with it at post-test (Z= -3.01, p=0.003). Data from semi-structured interviews confirm quantitative results; participants report increased feelings of compassion, confidence and safety when handling aggressive/violent patients. Discussion:The RESPECT training had a significant impact on attitudes towards management and causes of aggression within this sample. Participants reported a change on the approach to incidents of violence/aggression, primarily seeking to understand the cause of the outbreak and implementing non-physical strategies before applying traditional forms of management such as restrain or involuntary medication.