Cross-cultural Adaptation And Applicative Research Of The Management Of Aggression And Violence Attitude Scale (MAVAS) In Emergency Department

Objective:(1)The study introduced the Management of Aggression and Violence Attitude Scale(MAVAS)to mainland China with the rigorous cross-cultural adaptation,and finally formed the Chinese version scale that is suitable for mainland China;(2)Using the revised Chinese version of the scale to investigate the nurses'attitude towards patient violence of emergency department from 6 tertiary general hospitals in Taiyuan,Shanxi province,and to obtain a preliminary understanding of the current status of the emergency nurses'attitudes to the causes and management of patient violence in the city.Analyzing the influencing factors so that the managers could propose appropriate interventions to ensure the rights of the nurses and promote the improvement of patient satisfaction.Methods:The study consists of two phases.The first phase is the cross-cultural adaptation of the Management of Aggression and Violence Attitude Scale(MAVAS)(translation and psychometric properties),and the second phase is the application of adjusted scale to evaluate the nurses'attitude of the emergency department in Taiyuan.(1)The cross-cultural adaptation of the Management of Aggression and Violence Attitude ScaleFirstly,the researcher contacted with Dr.Joy Duxbury and Prof.Wai Kit Wong by E-mail,who are the authors of the original scale,explained the reasons for requesting and obtained the authorization.This study followed the cross-cultural adaptationguidelinesprovidedbyAAOS,accordingtothe"forward translation--integration--back translation--peer review--semantic analysis"translated the original scale and evaluated the reliability and validity of the revised scale through the investigation of 325 ED nurses with a convenient sampling method.The data was analyzed with SPSS 23.0 and Lisrel8.7 statistical software,and the critical ratio method and correlation coefficient were used to analyze the items of the scale,the content validity was assessed by Content Validity Index(CVI)through the experts and the construct validity of the scale was tested by confirmatory factor analysis.The validity was assessed by internal consistency,split-half reliability and test-retest reliability,finally forming the Chinese version of MAVAS.(2)The applicative research of the Management of Aggression and Violence Attitude Scale in the Emergency Department325 emergency department nurses from six tertiary general hospitals in Taiyuan,Shanxi Province were selected with a convenient sampling method,which as the research subjects to conduct a questionnaire survey.The questionnaire included the nurse's general demographic questionnaire and the Chinese version of MAVAS.The collected data was analyzed with descriptive analysis,non-parametric test and multiple stepwise regression analysis and other statistical methods,and analyzing the status and influencing factors of nurses'attitudes.Results:(1)The Chinese version of MAVAS had a excellent feasibility.The nurses actively cooperated with the survey and the average time for completing the questionnaire was about 8 minutes,and the response rate is 95.14%and the effective rate is 98.48%.(2)With a strict cross-cultural adaptation,the Chinese version of the Management of Aggression and Violence Attitude Scale has a total of 25 items,which are divided into4 dimensions:5 items for internal reasons dimension,3 for external reasons dimension,5 items for the interactional reason dimension and 12 items for the management dimension.(3)The internal consistency was satisfactory(the Total Scale Cronbach's?=0.938,Subscales Cronbach's?=0.741-0.898),and split-half reliability was 0.914,Subscales split-half reliability=0.650-0.889,and test-retest reliability over 2-week was good(Scale Pearson's coefficient=0.996,Subscales Pearson's coefficient=0.801-0.963).The average Scale-Content Validity Index was 0.904,and the Item-Content Validity Index ranged from 0.80 to 1.00.The study was tested using Confirmatory Factor Analysis by LISREL 8.7,and?~2/df of the scale was 4.781<5,NFI(0.91)?NNFI(0.92)?CFI(0.93)?IFI(0.93)>0.90,indicating that the scale construct validity fitted better.(4)The median score of the Chinese version of the Management of Aggression and Violence Attitude Scale was 3.52,and 3.80 for the internal reason,3.67 for the external reason,3.40 for the interactional reason and 3.33 for the management.Among them,gender,the years working experience of nursing and the duration of emergency work are the main factors affecting the whole scale and internal reasons.Marital status and education degree are the main factors that affect external causes.The number of years of nursing work is the main factor affecting the interaction,and education level and employment form are impact management.(5)The incidence of patient violence suffered by nurses during the past 6 months in the emergency department of Taiyuan was 69.8%,mostly in verbal abuse(60.6%).Conclusion:(1)The Chinese version of MAVAS had an excellent feasibility.It was found to be a valid and reliable tool to assess nurses'attitude towards patients'violence in emergency department in mainland of China.(2)The median score of the attitudes of nurses in the ED of hospitals in Taiyuan was3.52.Among them,nurses scored the highest on attitudes to violence related to patients,and the attitude towards management was the lowest.Managers should pay attention to further improve nurses'ability to manage violence.The main factors influencing nurses'attitudes are gender,the years of nursing and emergency experience.The administrators need to propose specific improvement measures and strengthen training for nurses so as to ensure the rights of nurses,to improve patient satisfaction and organizational efficiency,and to reduce medical costs,which provides a new idea to promote the healthier and vigorous development of Chinese medical and health undertakings.