Employee attitudes towards aggression in persons with dementia: Readiness for wider adoption of person‐centered frameworks
Authors: Burshnic V. L. , Douglas N. F. , Barker R. M. 
Published: January 2018

Accessible SummaryWhat is known on the subjectPerson‐centered care, as compared to standard approaches, is a widely accepted, evidence‐based approach for managing aggressive behaviour in persons with dementia.The attitudes, beliefs and values of long‐term care and mental health nursing employees are important prerequisites to implementing person‐centered practices.Research shows that nursing employees typically support person‐centered approaches; however, less is known about the attitudes of non‐nursing employee groups.What this paper adds to existing knowledgeNurse managers and administrators tended to agree with person‐centered approaches for managing aggression in dementia, suggesting some prerequisites are in place to support wider adoption of person‐centered frameworks.Employees with more resident contact tended to support person‐centered approaches the least, suggesting discipline‐specific trainings may not be adequate for preparing frontline staff to use person‐centered techniques.Attitudes towards aggressive behaviour may be especially varied and contradictory within certain employee groups, providing implications for facility‐wide initiatives.Implications for practicePerson‐centered values and practices should be monitored and reinforced across the organization.Person‐centered trainings should be interdisciplinary in nature and focused on care areas, such as mealtime or bathing.Long‐term care facilities should consider allowing nurse management and registered nurses to share the burden of direct resident care with frontline employees on a more regular basis.AbstractIntroductionImplementing person‐centered care requires shared attitudes, beliefs and values among all care employees. Existing research has failed to examine the attitudes of non‐nursing employees.AimThis study examined attitudes towards aggression among nursing and non‐nursing employees to address gaps in existing research and assess readiness for wider adoption of person‐centered frameworks.MethodTheManagement of Aggression in People with Dementia Attitude Questionnairewas used to survey attitudes of employees in Michigan‐based nursing homes.ResultsOverall, employees preferred person‐centered over standard approaches. Job title was a significant predictor of paradigm support. Frontline employees were found to support person‐centered attitudes the least. Wide‐ranging responses were noted within employee groups.DiscussionJob title may influence the degree to which an employee supports and utilizes person‐centered approaches. Employees with the most contact with persons with dementia may be the least likely to implement person‐centered approaches. In contrast to prior studies, years of experience was not a significant predictor of attitude towards aggressive behaviour. Wide‐ranging responses indicate that employee attitudes are varied and complex.ImplicationsPerson‐centered approaches should be trained within care areas rather than individual employee groups. Programs should be interdisciplinary and seek to establish a shared understanding of person‐centered beliefs and values.