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Affiliation
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Psychology Department, Royal Melbourne Hospital, Parkville, Melbourne, Australia. caroline.fisher@healthscope.com.au. |
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Abstract
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AIMS AND OBJECTIVES: A systematic review of aggression in an inpatient Huntington's cohort examining rates, types and antecedents.
BACKGROUND: Although the prevalence of aggression in Huntington's disease is high, research into this problematic behaviour has been limited. Few studies have investigated the nature of aggressive behaviour in Huntington's or antecedents that may contribute to its occurrence.
DESIGN: A systematic, double coded, electronic medical file audit.
METHODS: The electronic hospital medical records of ten Huntington's inpatients were audited for a 90 day period using the Overt Aggression Scale-Modified for Neurorehabilitation framework, yielding 900 days of clinical data.
RESULTS: Nine out of ten clients exhibited aggression during the audit period. Both verbal (37.1 percent) and physical aggression (33.8 percent) were common, along with episodes of mixed verbal and physical aggression (15.2 percent), while aggression to objects/furniture was less prevalent (5.5 percent). The most common antecedent to aggressive episodes was physical guidance with personal care, far exceeding any other documented antecedents, and acting as the most common trigger for four out of the nine clients who exhibited aggression. For the remaining five clients there was interindividual heterogeneity in susceptibility to specific antecedents.
CONCLUSION: In sufferer's with mid to late stage Huntington's, particular care should be made with personal care assistance due to the propensity for these procedures to elicit aggression. However, given the degree of interindividual heterogeneity in susceptibility to specific antecedents, individualised behaviour support and sensory modulation interventions may be the most useful in identifying triggers and managing aggressive episodes. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Language: en |