000109572 001__ 109572
000109572 005__ 20220208123552.0
000109572 0247_ $$2doi$$a10.1002/14651858.CD011860.pub2
000109572 0248_ $$2sideral$$a120308
000109572 037__ $$aART-2020-120308
000109572 041__ $$aeng
000109572 100__ $$aGeoffrion, S.
000109572 245__ $$aEducation and training for preventing and minimizing workplace aggression directed toward healthcare workers
000109572 260__ $$c2020
000109572 5060_ $$aAccess copy available to the general public$$fUnrestricted
000109572 5203_ $$aBackground: Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression.
Objectives: To assess the effectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates. Search methods: CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies. Selection criteria: Randomized controlled trials (RCTs), cluster-randomized controlled trials (CRCTs), and controlled before and after studies (CBAs) that investigated the effectiveness of education and training interventions targeting aggression prevention for healthcare workers. Data collection and analysis: Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach.
Main results: We included nine studies—four CRCTs, three RCTs, and two CBAs—with a total of 1688 participants. Five studies reported episodes of aggression, and six studies reported secondary outcomes. Seven studies were conducted among nurses or nurse aides, and two studies among healthcare workers in general. Three studies took place in long-term care, two in the psychiatric ward, and four in hospitals or health centers. Studies were reported from the United States, Switzerland, the United Kingdom, Taiwan, and Sweden. All included studies reported on education combined with training interventions. Four studies evaluated online programs, and five evaluated face-to-face programs. Five studies were of long duration (up to 52 weeks), and four studies were of short duration. Eight studies had short-term follow-up (< 3 months), and one study long-term follow-up (> 1 year). Seven studies were rated as being at "high" risk of bias in multiple domains, and all had "unclear" risk of bias in a single domain or in multiple domains. Effects on aggression. Short-term follow-up. The evidence is very uncertain about effects of education and training on aggression at short-term follow-up compared to no intervention (standardized mean difference [SMD] -0.33, 95% confidence interval [CI] -1.27 to 0.61, 2 CRCTs; risk ratio [RR] 2.30, 95% CI 0.97 to 5.42, 1 CBA; SMD -1.24, 95% CI -2.16 to -0.33, 1 CBA; very low-certainty evidence). Long-term follow-up. Education may not reduce aggression compared to no intervention in the long term (RR 1.14, 95% CI 0.95 to 1.37, 1 CRCT; low-certainty evidence). Effects on knowledge, attitudes, skills, and adverse outcomes. Education may increase personal knowledge about workplace aggression at short-term follow-up (SMD 0.86, 95% CI 0.34 to 1.38, 1 RCT; low-certainty evidence). The evidence is very uncertain about effects of education on personal knowledge in the long term (RR 1.26, 95% CI 0.90 to 1.75, 1 RCT; very low-certainty evidence). Education may improve attitudes among healthcare workers at short-term follow-up, but the evidence is very uncertain (SMD 0.59, 95% CI 0.24 to 0.94, 2 CRCTs and 3 RCTs; very low-certainty evidence). The type and duration of interventions resulted in different sizes of effects. Education may not have an effect on skills related to workplace aggression (SMD 0.21, 95% CI -0.07 to 0.49, 1 RCT and 1 CRCT; very low-certainty evidence) nor on adverse personal outcomes, but the evidence is very uncertain (SMD -0.31, 95% CI -1.02 to 0.40, 1 RCT; very low-certainty evidence). Measurements of these concepts showed high heterogeneity. Authors'' conclusions: Education combined with training may not have an effect on workplace aggression directed toward healthcare workers, even though education and training may increase personal knowledge and positive attitudes. Better quality studies that focus on specific settings of healthcare work where exposure to patient aggression is high are needed. Moreover, as most studies have assessed episodes of aggression toward nurses, future studies should include other types of healthcare workers who are also victims of aggression in the same settings, such as orderlies (healthcare assistants). Studies should especially use reports of aggression at an institutional level and should rely on multi-source data while relying on validated measures. Studies should also include days lost to sick leave and employee turnover and should measure outcomes at one-year follow-up. Studies should specify the duration and type of delivery of education and should use an active comparison to prevent raising awareness and reporting in the intervention group only. Copyright
000109572 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000109572 590__ $$a9.266$$b2020
000109572 591__ $$aMEDICINE, GENERAL & INTERNAL$$b11 / 169 = 0.065$$c2020$$dQ1$$eT1
000109572 592__ $$a1.319$$b2020
000109572 593__ $$aPharmacology (medical)$$c2020$$dQ1
000109572 593__ $$aMedicine (miscellaneous)$$c2020$$dQ1
000109572 655_4 $$ainfo:eu-repo/semantics/review$$vinfo:eu-repo/semantics/publishedVersion
000109572 700__ $$aHills, D.J.
000109572 700__ $$aRoss, H.M.
000109572 700__ $$aPich, J.
000109572 700__ $$aHill, A.T.
000109572 700__ $$aDalsbø, T.K.
000109572 700__ $$aRiahi, S.
000109572 700__ $$0(orcid)0000-0001-6469-9189$$aMartínez-Jarreta, B.$$uUniversidad de Zaragoza
000109572 700__ $$aGuay, S.
000109572 7102_ $$11005$$2613$$aUniversidad de Zaragoza$$bDpto. Farmacología y Fisiolog.$$cÁrea Medicina Legal y Forense
000109572 773__ $$g2020, 9 (2020), CD011860 [79 pp.]$$pCochrane Database of Systematic Reviews$$tCochrane Database of Systematic Reviews$$x1469-493X
000109572 8564_ $$s867488$$uhttps://zaguan.unizar.es/record/109572/files/texto_completo.pdf$$yVersión publicada
000109572 8564_ $$s823213$$uhttps://zaguan.unizar.es/record/109572/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000109572 909CO $$ooai:zaguan.unizar.es:109572$$particulos$$pdriver
000109572 951__ $$a2022-02-08-11:18:44
000109572 980__ $$aARTICLE