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Use of restraints in patients with violent and aggressive behavior.
LÖFFELMANNOVÁ, Silvie
This Diploma Work is focussed on application of restrictive agents with patients who are afflicted with violent and aggressive behaviour. The up-to-date civilization has brought, expect for further changes, also a very principal change that presents a substantial increase of psychic and psychiatric disorders. That is why it is necessary to think about the question how to prevent aggression and violence in medical facilities. It is evidenced that more cases of patients showing aggressive and violent behaviour occur nowadays. What are preventive news in occurrence of aggression while hospitalization? What are legal news and standards applied to limiting and restrictive means? It is not a rule any more that we meet a patient with aggressive or violent behaviour only in psychiatric departments. However, we can meet those patients in any departments and facilities of healthcare. The Diploma Work is split into a theoretical and a practical section. In the theoretic part we state the human psyche evolution, aggression and violence origination and evolution, kinds of aggression, violent behaviour and demographic occurrence thereof within existing population. Further on, we mention kinds of restrictive measures, their indications and the statutory framework dealing with this problem area. A status of nurse and a nurse competence in that area represent an important element of the theoretic work. Four objectives were set in the practical part of the Work. The first goal was aimed to find out work fastidiousness of nurse providing care to patients with aggressive and violent behaviour. The second goal had to recognise what was taken for the greatest problem area within nursing care at treatment of patients with aggressive and violent behaviour. The third goal was to find out any benefits and shortages in the application of restrictive agents at treatment of patients with aggressive and violent behaviour. Finally, the fourth goal was set to find out and compare nursing staff?s opinions on the application of restrictive agents and main problems in that field. The above objectives were met. Based on those objectives research questions were defined. What is the work fastidiousness of nurses who take care of patients with violent and aggressive behaviour? What is considered by the nurses as the most problem area within providing healthcare to aggressive patients? What is the positive application of restrictive agents with patients showing aggressive or violent behaviour? What special reform should be performed in the application of restrictive - limiting means? The asked questions were answered. A qualitative investigation was used to work out the Diploma Work. Collection of needed data was carried out by help of procedure of a non-standardized, structured dialogue. Our investigation took place in the psychiatric department of Klatovy Hospital a.s. , the psychiatric department of University Hospital in Plzeň , Psychiatric Medical Institution in Dobřany and other more departments. The nurses? answers were compiled in casuistries from which though maps were made up. The described investigation was running from January to July 2011. The results of my Diploma Work might serve as a feedback for the hospitals and medical institutions in which the above investigation was performed. An educative programme for nurses was created.
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