Highlights

• Emotional labour of caregivers who take care of aggressive brain-injured patients is explored.

• Emotional labour depends on the supposed “consciousness” of the patient about their aggressive behaviors.

• The social representations could constitute knowledge for dealing with situations and impacting their emotional regulation.

• Suppressing emotions in order not to transmit them allows caregivers to keep control of the situation.

Abstract
Background
Aggressive behaviours are common with people who have suffered brain injuries and induce difficult emotions among certified nursing assistants and medical-psychological assistants who take care of them. These caregivers carry out emotional labour whose content and strategies are little known.

Aim
The study explores the emotional labour of certified nursing assistants and medical-psychological assistants faced with the aggressive behaviours of brain-injured patients.

Methods
Semi-structured interviews were conducted with 37 caregivers. Interviews were analysed via a thematic content analysis.

Results
The analysis shows that the emotional labour of caregivers varies in accordance with the state of “consciousness” or “non-consciousness” that they attribute to the brain-injured patient with regard to this aggressive behaviour. This is a deep acting strategy. Moreover, caregivers shut off their emotions in order not to transmit them to the patient. This surface acting has the first objective for the caregiver of maintaining control of the situation and a second objective of protecting the patient emotionally and therefore of being perceived as a “good” caregiver. Emotional labour also meets a need to preserve the professional self-image and professional status negatively affected in the interaction with the aggressive brain-injured patient.

Conclusions
Our study specifies the different strategies of the emotional labour of caregivers and their circumstances of use when they are confronted with aggressive behaviour by brain-injured patients. Targeted support for this emotional labour, such as training and practical analysis, is essential for the development of care practices promoting a caring relationship.

Magali Huet, Lionel Danya, Thémistoklis Apostolidis
Archives of Psychiatric Nursing, Volume 32, Issue 3, June 2018
https://doi.org/10.1016/j.apnu.2017.11.026
https://www.sciencedirect.com/science/article/pii/S0883941717301607

Emotional Labour of Caregivers Confronted With Aggressive Brain-injured Patients – 2018