Working with patients with an acquired brain injury: staff experiences of inappropriate sexualised behaviour

Part One: Literature Review Purpose: To explore the qualitative literature regarding staff experiences of challenging behaviour and to provide an overview of the quality of this research. Method: A literature search was conducted using six databases to highlight relevant papers. Specific key terms and inclusion and exclusion criteria were applied. Results: Several themes emerged from the reviewed studies, including understanding the behaviour, losing control, emotional reactions, managing a response, coping strategies, the relationship with clients and professionalism. However, many studies lacked methodological rigour. Conclusions: Further research investigating coping strategies for care staff and effective support mechanisms is indicated. Staff experiences should be acknowledged in order to promote better psychological and emotional wellbeing. Part Two: Research Report Objectives: To explore staff experiences of sexualised behaviour from patients with an acquired brain injury. Method: The data from ten semi-structured interviews and a diary from one participant was analysed using Interpretative Phenomenological Analysis (Smith, 1996). Results: Three key themes emerged: Psychological Responses, The Continuing Ability To Cope and Evolving Relationships. Conclusions: The results suggest that sexualised behaviour directed towards staff affects their emotional and psychological wellbeing. Participants identified multiple coping strategies to help them but specifically highlighted the importance of shared experience and shared understanding within the work support system. The clinical implications, such as enabling appropriate support systems within the work environment, include prioritising the psychological wellbeing of staff in clinical settings. Part Three: Critical Appraisal Reflections regarding the overall research process are provided. Barriers and facilitating factors as well as practical issues of interest are discussed, including the journey taken, reflexivity, the analysis process, the write up and limitations of IPA as the chosen methodology.