Factors associated with the psychological response of nurses’ victims of inpatients violence in a psychiatric facility for adults with intellectual disability In Cape Town

Abstract

Background and Research Problem: It is well-known that nurses around the world are exposed to various forms of violence at their workplaces. In psychiatric facilities, many of these incidents are perpetrated by patients against nurses. There is a perception that the current legislation and regulations in the country do not adequately protect psychiatric nurses (health care workers in general) against workplace violence. The preliminary literature suggested that most quantitative studies on workplace violence in psychiatric facilities have concentrated on secondary and tertiary psychiatric hospitals looking at the prevalence, the association between demographic factors and violence behaviour, nurses‟ therapeutic responses, and the impacts on the quality of care. Studies on workplace violence in a psychiatric facility for adults with intellectual disability in the country are limited. Secondly, it appeared from the preliminary literature review that similar studies have not looked at this phenomenon from the individual resilience perspective.Therefore, this study will seek to determine the factors associated with the psychological response of nurses‟ victims of inpatient violence in a psychiatric facility for adults with intellectual disability in Cape Town.Aim: To determine factors associated with the psychological response of nurses‟ victims of in-patient violence in a psychiatric facility for adults with intellectual disability in Cape Town.Objectives: To describe the (1) individual resilience of nurses working at a psychiatricfacility for adults with intellectual disability; (2) psychological response of nurses‟ victims of in-patients‟ violence at a psychiatric facility for adults with intellectual disability; and (3) association between the individual resilience characteristics and the psychological responses of nurses victims of in-patients‟ violence in a psychiatric facility for adults with intellectual disability.Methodology: Descriptive-exploratory design using a quantitative approach was used.All categories of nurses (professional nurse, enrolled nurse and enrolled nursing assistance) working at the psychiatric facility for adults with intellectual disability were eligible for the study. Convenient sampling was conducted to select 127 participants who met the inclusion criteria. Self-administered questionnaire was used to collect data. Data was analysed using the SAS V9.3 computer programme. Ethical clearance was obtained from University as well as approval from the management of the psychiatric facility prior to approaching the study participants. Results: The results of the study showed high level of resilience among nurses on Assessment of Resilience Scale (82.9%, n=104); nurses psychological responses to violence were equally distributed between avoidance (mean =4.65 and SD=1.36), intrusion (mean= 4.55 and SD=1.50), hyper arousal (mean=4.46 and SD=1.60) resulting in total mean of 13.67 (SD=4.14) on the revised Impact of Event Scale (IES-R). Measure of association between resilience and the impact of violence on the psychological wellbeing of nurses showed that nurses with high resilience score (82.9%, n=104) fitted the symptoms of PTSD on the IES-R. Spearman Rank correlations (r) analysis showed the total scores of IES-R (r=0.04, p=0.68), avoidance (r=0.01, p= 0.34), intrusion (r=0.08,p=0.34), and hyper-arousal (r= -0.002, p=0.97). Further research looking at the nurses‟ reliance and their responses using resilience theory is needed.