Joy Duxbury is Professor of Mental Health Nursing. She has a clinical background in acute mental health and is an avid believer in the promotion of the service user view in both practice and academia. Accordingly the bulk of her research work and publications has been on staff and patient perspectives on aggression and relational experiences in inpatient services. Joy is the Chair of the European Research Group on Violence in Psychiatry. She is the founder and President of the International Research Collaborative on Clinical Aggression and an honorary fellow and associate chair at Melbourne University.


Staff training programs are central to preventing patient aggression, however a limited number of studies have evaluated the effect of training on both learning and organizational outcomes. We evaluated the impact and sustainability of a violence prevention, training program in 18 emergency departments across Victoria, Australia. We measured the impact of the program on staff attitudes to the management and prevention of clinical aggression and frequency and type of clinical responses to aggression and violence using a pre and post design. 471 participants completed both pre and post-test measures including the Management of Aggression and Violence Attitude Scale (MAVAS) and interviews. Statistically significant shift s were observed in 5/23 items of the scale (Wilcoxon Signed Ranks Test: p ≤0.01). Despite training, participants remained undecided if it was possible to prevent patient aggression, and unsure about the use of physical restraint. Twenty eight (82.3%) managers and trainers were interviewed about the impact of the program. Overall, their perceptions were consistent with the significant shift s observed in the survey items. A sustained improvement in participation in training and the use of preventative strategies to manage patient aggression was observed. We found limited evidence to demonstrate that the program significantly modified staff attitudes toward the prevention of patient aggression. Notwithstanding this result the managers and trainers who were interviewed about the program did perceive changes in the way staff worked to prevent patient aggression in practice.

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