Factors associated with aggressive behaviour in persons with cognitive impairments using home care services: A retrospective cross-sectional study

Aim: This study aimed to investigate the frequency of documented aggression, on the part of cognitively impaired individuals, against health professionals in home care services and to highlight related factors. Design: A retrospective cross-sectional study was conducted using data obtained from the nursing documentation of six home care service organizations in Switzerland. Methods: We analysed the nursing documentation of 1,186 clients in six home care services, between July 2019-September 2019, using the Cohen-Mansfield Agitation Inventory. We conducted a factor analysis as well as a descriptive data analysis and logistic regression using IBM SPSS Statistics. Results: A factor analysis revealed in five factors, of which three represented aggressive behaviour in the sample. These factors were physically aggressive behaviour, verbally aggressive behaviour and importunate behaviour. Aggressive incidents, documented in the nursing records of 14.7% of clients in our sample, tended to be associated with cognitive, communication and mobility difficulties. Impact statement: This retrospective cross-sectional survey gives an overview of the frequency and forms of documented aggressive behaviour on the part of persons with cognitive impairments towards health professionals in home care services. One of the motivating factors for this study was the awareness that aggressive behaviour on the part of clients may stress health professionals in various ways which in turn may have an impact on the quality of care provided. The study revealed that healthcare specialists, rather than more qualified general or psychiatric nurses, were routinely assigned to assisting such clients and therefore specific educational and training interventions for these specific group of staff are indicated.

Automated summary

This study aimed to investigate the frequency of documented aggression towards health professionals in home care services by cognitively impaired individuals. Factors such as cognitive, communication, and mobility difficulties were found to be associated with aggressive incidents. Specific educational and training interventions for healthcare specialists assisting clients with cognitive impairments are indicated based on the study findings.