Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis.
AIM
Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences.


BACKGROUND
Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear.


INTRODUCTION
Challenging behaviour of residents can be enervating for nurses and may lead to stress. Although stress in general is associated with negative outcomes, an overview of stress in this context would be a welcome addition to the field.


METHOD
Concept analysis according to Walker and Avant.


RESULTS
Identified antecedents of stress: physical and verbal aggression, conflicts, excessive demands and being unresponsive (residents), age, experience, tenure, nursing level and training (nursing staff). Defining attributes: disturbed homoeostasis and the personal appraisal of the situation. Identified consequences regard health, psychological aspects and behaviour.


DISCUSSION
Intervening in the identified factors may contribute to prevention of stress in nursing staff.


LIMITATIONS
Given a lack of strong empirical studies, our analysis is not based on a high level of evidence and needs to be tested. Papers from before 1990 might have been missed.


CONCLUSION
The concept analysis revealed that nursing staff stress in the context of challenging behaviour may result from resident and nursing staff factors. Besides health and psychological consequences, behavioural consequences can enormously impact the well-being of residents.


IMPLICATIONS
Application in daily care to support teams in influencing resident and nursing staff factors could prevent stress, for instance using behavioural management training or recruiting higher educated nursing staff. Given the increasing complexity of care, creating specialized units with specifically trained staff for different groups of people with dementia may be desirable.
['Hazelhof|T J G M|TJ|', 'Schoonhoven|L|L|', 'van Gaal|B G I|BG|', 'Koopmans|R T C M|RT|', 'Gerritsen|D L|DL|']
D000368:Aged D000369:Aged, 80 and over D003704:Dementia D006801:Humans D009735:Nursing Homes D009740:Nursing Staff D010820:Physicians
Nursing Staff Stress Challenging behaviour Residents Dementia Concept analysis Prevention