Interventions to Address Behavioral Issues Among Medical-Surgical Patients: An Integrative Review.
TL;DR
Staff education and institutional support enhance health care workers' preparedness, but evidence for reducing behavioral incidents is limited, and future trauma-informed, interdisciplinary approaches are needed to foster sustainable improvements in patient and staff well-being.
Abstract
Purpose
The current integrative review synthesized research on interventions aimed at managing behavioral symptoms among hospitalized patients in medical-surgical units.
Method
Six databases (CINAHL Complete, Medline Complete, Medline Ovid, Web of Science, Health Source: Nursing/Academic, and PubMed) were searched through February 2025, along with reference lists from prior reviews. Of 509 articles screened, 25 articles representing 24 studies met inclusion criteria. Two reviewers independently screened and assessed study quality using design-appropriate tools.
Results
Most studies used quasi-experimental designs (79%) and targeted nursing staff (56%), emphasizing education-based interventions, such as didactic sessions, role play, and de-escalation training. Improved staff confidence (n = 11) and knowledge (n = 6) were frequently reported, whereas only three studies demonstrated reduced patient aggression. Study quality was generally low to moderate, with wide variation in measurement tools.
Conclusion
Staff education and institutional support enhance health care workers' preparedness, but evidence for reducing behavioral incidents is limited. Future trauma-informed, interdisciplinary approaches are needed to foster sustainable improvements in patient and staff well-being.