Aggressive behaviour,staff attitude and staff perception of patients on two continuing care psychogeriatric wards

Levels of aggressive behaviour on continuing care psychogeriatric wards are high. Various staffing factors, potentially amenable to improvement by training, are thought to be associated with aggressive behaviour. The relationship between aggressive behaviour in patients, measured by the Rating Scale for Aggressive Behaviour in the Elderly (RAGE), and the attitude of the nursing staff towards the patient and their perception of the patient, measured by the Modified Alienation Scale (MAS), was examined in a prospective study over 4 months on two continuing care psychogeriatric wards. There was a moderately strong correlation between the RAGE total score and the MAS total score (r = + 0.67) and its sub-scales of feeling distant from the patient (r = + 0.44), deliberate use of symptoms by the patients (r = + 0.36), alienation of the patient (r = + 0.85) and variable mood in the patient (r = + 0.77). Intervention studies designed to either directly reduce aggressive behaviour or reduce aggressive behaviour by improving staff attitude and perception, or both, in a range of settings, are suggested to identify clinically effective and cost-effective strategies for reducing aggressive behaviour.