{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:35:33Z","timestamp":1790141733924,"version":"4.0.1"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012141","name":"University Hospitals Bristol and Weston NHS Foundation Trust","doi-asserted-by":"crossref","award":["2019-Spr-03"],"award-info":[{"award-number":["2019-Spr-03"]}],"id":[{"id":"10.13039\/100012141","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,26]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate staff experiences of, and approaches to behaviour that challenges displayed by patients with dementia in the emergency department (ED). Behaviour that challenges is defined as \u2018actions that detract from the well-being of individuals due to the physical or psychological distress they cause within the settings they are performed\u2019, and can take many forms including aggressive physical actions, shouting and verbal aggression and non-aggressive behaviour including repetitive questioning, inappropriate exposure and resistance to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Mixed-methods study consisting of an online survey and semistructured telephone interviews. Quantitative data were analysed and presented using descriptive statistics. Qualitative data were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The EDs of three National Health Service (NHS) Hospital Trusts in Southwest England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Multidisciplinary NHS staff working in the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-two online survey responses and 13 telephone interviews were analysed. Most (24\/36, 67%) survey respondents reported that they had received general training in relation to dementia in the last 2\u20135 years, however, less than a fifth (4\/23, 17%) had received any ED-specific dementia training. All (48\/48) felt that behaviour that challenges could potentially be prevented, though resource constraints and practice variation were identified. Four main themes emerged from the qualitative data: (1) the \u2018perfect storm\u2019 of the ED; (2) behaviour that challenges is preventable with the right resources; (3) improvisation and (4) requirement for approaches that are specific to the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of this study suggest that ED staff do not feel that they are prepared to respond effectively to behaviour that challenges displayed by people living with dementia. Future work could adapt or develop an intervention to support ED staff in responding to behaviour that challenges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075022","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T12:35:15Z","timestamp":1691152515000},"page":"e075022","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["How do emergency department staff respond to behaviour that challenges displayed by people living with dementia? A mixed-methods study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9118-4620","authenticated-orcid":false,"given":"Laura","family":"Goodwin","sequence":"first","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Liddiard","sequence":"additional","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sera","family":"Manning","sequence":"additional","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Richard","family":"Benger","sequence":"additional","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Carlton","sequence":"additional","affiliation":[{"name":"Emergency Department, North Bristol NHS Trust, Westbury on Trym, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Cheston","sequence":"additional","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Hoskins","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Taylor","sequence":"additional","affiliation":[{"name":"Research Design Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5044-5145","authenticated-orcid":false,"given":"Sarah","family":"Voss","sequence":"additional","affiliation":[{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2025121514395951000_13.8.e075022.1","unstructured":"Alzheimer\u2019s Research UK . 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