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A Quantitative and qualitative inquiry into dementia and physically aggressive behaviour in residential aged care


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Cubit, KA (2009) A Quantitative and qualitative inquiry into dementia and physically aggressive behaviour in residential aged care. PhD thesis, University of Tasmania.

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Australia has an ageing population with a proportionate increase in the number of
people with dementia. Subsequently, there are an increasing number of people
living in residential aged care with dementia. Indirect evidence suggests
behavioural symptoms associated with dementia are of concern to nursing and
care staff but there is little research that explores how and why this is the case.
The behavioural symptoms of dementia are referred to as Behaviours of Concern
(BoC) in this thesis.
This study examines the extent to which BoC are of concern to nursing
and care staff in the Tasmanian residential aged care sector. A mixed methods
approach comprising two distinct phases was undertaken.
The first phase was a general survey to determine the incidence and
impact of BoC to provide a contextual perspective. The focus was on physically
aggressive behaviour in Tasmanian Residential Aged Care Facilities (RACFs).
This was important because of two identified gaps in the literature: a lack of
clarity found in the reporting of incidence of physically aggressive behaviours;
and an ambiguity surrounding the impact of physically aggressive behaviour on
nursing and care staff.
The second phase focussed on the incidence, impact, understanding and
management of physically aggressive behaviour in one RACF from multiple
perspectives to determine how and why it was of concern to nursing and care
staff. Data were collected using multiple methods including a survey, a clinical
audit, structured observation, participant observation, group discussions and
interviews with nursing and care staff. The literature highlighted that physically aggressive behaviour among
residents with dementia is a significant issue for nursing and care staff in RACFs.
This study found a low incidence of physically aggressive behaviour among
people with dementia, but that when it occurred it had a high impact on nursing
and care staff. The high impact is attributed to a lack of capacity within the aged
care sector to manage such behaviour effectively. This lack of capacity was due to
a number of key factors. These included: the absence of a formal dementia
diagnosis; a shortage of skilled nursing staff able to understand and assess
individual residents’ needs; a nursing and care staff shortage restricting the
possibility of delivering one-to-one nursing care; a culture of tolerance to
physically aggressive behaviours; a culture of resistance to the implementation of
behaviour management strategies; problems with the educational preparation of
staff; and ineffective communication between nursing and care staff regarding
behaviour management.

Item Type: Thesis (PhD)
Copyright Holders: The Author
Additional Information:

Copyright 2009 the Author. The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s) -

Date Deposited: 11 Nov 2013 03:03
Last Modified: 15 Sep 2017 01:06
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