"A pilot study of MAP - a program for handling of aggressive behaviour in psychiatric wards. An evaluation of mediating mechanisms".

introductionStaff working at inpatient psychiatric hospitals are at greater risk of being exposed to workplace aggression, with an incidence rate over 32% worldwide. Workplace aggression includes behaviours or actions that are meant to inflict harm or injury, verbally or physically, to another person. Exposure to aggressive behaviour is associated with negative work-related outcomes and higher levels of coercive measures in mental health care facilities. Several interventions aimed to prevent or reduce workplace violence have been developed, and staff training programs have shown to have some efficacy towards increasing staff knowledge and competence, in addition to reduce coercion to patients. "Management of Aggression Program (MAP)" is a Norwegian, nationally employed staff training program designed after classic triage from green to red, and is categorized as primary-, secondary- and tertiary prevention, with the aim to providing staff basic understanding of aggression, risk assessment, violence prevention, preventive communication, de-escalation, teamwork and self-regulation. This pilot study aims to explore the possible mediating mechanisms of MAP.

methodsA qualitative exploratory study design was used. Data was collected by repeated semi-structured interviews of four participants at two different timepoints, using thematic analysis to analyse the written transcripts. FINDINGS AND

conclusionsThe findings of this study suggest that themes within domain of cognitive reframing and contextualization might be the most important mediating mechanisms of the staff training program. The interviewed participants found the training program to be engaging, and the training provided the participants with knowledge and skills to be confident and conscious of their work. There is a lack of prior research or published studies about MAP, and similar programs, as of writing this report. Therefore, a need for further research on this topic is necessary. The findings of this study might be suitable for selection and operationalization of endpoints in future studies.