The impact of a brief psychoeducational intervention on hospital security personnel’s attitudes towards aggression and violence management at Cecilia Makiwane Hospital

Abstract

Background: Aggression and violence remain persistent challenges in healthcare settings, particularly in psychiatric and emergency units. Security personnel serve as frontline responders but frequently lack structured training in de-escalation techniques, increasing the risk of harm.
Aim: This study aimed to assess and improve security personnel’s attitudes towards the causes and management of aggression through a structured de-escalation training programme.
Setting: The study was conducted at Cecilia Makiwane Hospital, a regional academic facility in the Eastern Cape province of South Africa, housing the only public-sector mental health unit in Buffalo City Municipality.
Methods: A quasi-experimental single-group pre-test–post-test design was used. Security personnel completed an interactive educational programme incorporating discussions, role-play, and scenario-based exercises. The Management of Aggression and Violence Attitude Scale (MAVAS) was administered before and after the intervention. Data were analysed using paired-samples t-tests and multiple regression at a 5% significance level.
Results: Baseline MAVAS domain scores indicated moderate agreement with all four domains. Following the intervention, significant improvements were observed across all MAVAS domains (p ≤ 0.01), reflecting more positive attitudes towards aggression management. Female participants showed greater changes in environmental and interpersonal causes of aggression (B = −0.259, p = 0.003), while longer work experience predicted increased recognition of patient-related causes. Job rank and age were not significant predictors.
Conclusion: Structured de-escalation training effectively improved security personnel’s attitudes towards managing aggression and violence in a hospital setting.
Contribution: This study provides empirical evidence that context-specific de-escalation training for security personnel may support workplace safety and strengthen multidisciplinary collaboration in the South African setting.