Effect of Using Care Bundle in the Aggression Management of Patients With Psychotic Disorders
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 24
- 试验地点
- 2
- 主要终点
- Change in aggression risk during hospitalization
研究概览
简要总结
The aim of this sequential randomized controlled experimental design study is to develop an aggression care bundle approach in psychiatric care for patients with psychotic disorders, to use it in a psychiatric clinic, and to evaluate its results. The hypotheses it aims to test are as follows:
- The aggression management care bundle applied to patients with psychotic disorders in a psychiatric clinic will reduce the risk of developing aggression.
- The number of aggressive events in the patient group to whom the aggression management care bundle is applied will be less than the control group receiving routine care.
- The use of restrictive aggression management techniques in the clinic will decrease.
- The clinical compliance rate of the developed aggression management care bundle will be 95% and above.
详细描述
Psychopathology plays an important role in the emergence of aggression. Having a diagnosis of psychotic disorder or schizophrenia is an important psychopathology that leads to aggression. For these reasons, aggression and how to manage it is an ongoing problem in psychiatric clinics. The prevalence of aggressive behavior in psychiatric wards varies between 8-76%. The prevalence of aggression in schizophrenia patients is stated as 33.3%. This aggression can be verbal, directed towards objects/spaces, towards oneself or physical aggression towards others. Healthcare professionals in psychiatric wards are exposed to these aggressive events carried out by patients. It is reported that 25-85% of healthcare professionals working in psychiatric wards are exposed to aggressive events; the prevalence of aggression towards nurses varies between 11.4-97.6%. Over the years, some methods have been developed and used to manage aggression in psychiatric wards. Chemical and mechanical restraint and seclusion methods are still the leading methods used. There is a need for alternative and evidence-based interventions based on therapeutic nursing approaches to manage aggression in psychiatric wards, which can be easily adopted and implemented in the clinic. Therefore, it was aimed to develop and use the "care bundle" approach, which has been shown to improve patient outcomes in the literature, for aggression management in psychiatric wards. Care bundles are care tools that target a specific patient population, consist of 3-5 evidence-based approaches, and improve patient outcomes when used together. In this study, it was planned to develop the aggression management care package in phase 1, and evaluate the clinical use of the aggression management care bundle in phase 2. The aggression management care bundle was developed following the guidelines of The Institute for Healthcare Improvement.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Supportive Care
- 盲法
- Double (Participant, Care Provider)
盲法说明
Patients and nurses do not know which group they are in, or which experimental or control groups they are in. The first tests were taken after patient consent to ensure blinding, but without assignment to groups.
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Being between 18-65 years of age,
- •Being able to speak and understand Turkish,
- •Having one of the disorders within the scope of Schizophrenia and psychosis,
- •Being newly admitted to Bolu İzzet Baysal Mental Health and Diseases Hospital during the period the research was conducted,
- •Having scored 1 point or more on the Broset Violence Checklist or 65 points or more on the Buss-Perry Aggression Questionnaire.
排除标准
- •Not being able to give written informed consent,
- •Being the first time a patient has been admitted to a psychiatric clinic,
- •Having developmental delay or any other significant organic brain pathology.
结局指标
主要结局
Change in aggression risk during hospitalization
时间窗: up to 6 weeks (routine hospitalization period)
The primary outcome 1 measure of the study is change in aggression during hospitalization. Aggression risk will be measured in both groups with scales: Buss-Perry Aggression Questionnaire (BAQ):29-item scale measuring four aggression sub-dimensions on a 5-point Likert scale. Total score: 29-145. Higher scores indicate higher aggression risk. Change in aggression risk will be compared between hospitalization and discharge, and between control and experimental groups.
Change in aggressive events during hospitalization
时间窗: up to 6 weeks (routine hospitalization period)
The primary outcome 2 measure of the study is change in aggression during hospitalization. Aggressive events will be measured in both groups with this scale: Overt Aggression Scale:Assesses aggression through professional observation. Two sections: Aggressive Behavior and Attempts. Scores: Total Aggression (max 26) and Aggression Score (max 21). Measures severity and frequency of aggressive behavior. Change in aggressive events will be compared between hospitalization and discharge, and between control and experimental groups.
Change in aggression risk during 24 hours
时间窗: up to 6 weeks (routine hospitalization period)
The primary outcome 3 measure of the study is change in aggression during 24 hours. Aggression risk will be measured in both groups with scale: Broset Violence Checklist (BVC):Estimates 24-hour violence risk in acute psychiatric settings. Six behaviors scored 0 or 1. Total score: 0-6. 0 = low risk, 1-2 = medium risk, \>2 = high risk. Change in aggression risk in during 24 hours will be compared between hospitalization and discharge, and between control and experimental groups.
次要结局
- care bundle compliance rate(up to 6 weeks (routine hospitalization period))
研究者
Melisa BULUT
Research Assistant
Abant Izzet Baysal University