Caregivers facing violence in long-term care setting: A cross analysis of incident reports and caregivers speech

Abstract

Background: Workplace violence is frequent, especially in long-term care, but often unreported.

Aims: The aim of this study is to identify workers experiences and coping strategies when they face physical aggression from residents and assess the value of incident reports for violence follow-up.

Methods: This mixed method study is based on incident reports collected over 3 years from two different long-term care geriatric facilities in France and thematic analysis of 20 semi-structured interviews of nurses and nursing assistants.

Results: The reported frequencies of physical aggression among respondents range from none to daily aggression. Only 76 incident reports were submitted. Aggressions were under-reported by caregivers who often felt guilty for not having avoided them. Coping strategies included banalization and seeking support from colleagues. Incident reports can constitute a warning signal for the management team but are not a reliable tool for workplace violence follow-up.

Conclusions: Our study emphasizes the complexity of workplace violence prevention in long-lerm care settings. Proposals can be formulated to train and support caregivers, but a shift from a task-oriented organisation to a patient-centred approach seems necessary to reduce violence.

Implications for nursing management: Situations to be reported should be better defined, aggression reporting encouraged and judgmental attitudes toward reports discouraged.

Keywords: coping; incident reporting; mixed study; physical aggression; workplace violence.

FIGURE 1

Schematic representation of the data from the semi‐structured interviews concerning the mechanism of feeling of guilt (black arrows indicate positive actions and green/thick arrows negative actions)