Abderhalden Christoph, Needham Ian, Dassen Theo, Halfens Ruud, Haug Hans-Joachim, Fischer Joachim
Nursing and Social Education Research Unit, University Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
BMC Psychiatry. 2006 Apr 25;6:17. doi: 10.1186/1471-244X-6-17.
Patient aggression is a common problem in acute psychiatric wards and calls for preventive measures. The timely use of preventive measures presupposes a preceded risk assessment. The Norwegian Brøset-Violence-Checklist (BVC) is one of the few instruments suited for short-time prediction of violence of psychiatric inpatients in routine care. Aims of our study were to improve the accuracy of the short-term prediction of violence in acute inpatient settings by combining the Brøset-Violence-Checklist (BVC) with an overall subjective clinical risk-assessment and to test the application of the combined measure in daily practice.
We conducted a prospective cohort study with two samples of newly admitted psychiatric patients for instrument development (219 patients) and clinical application (300 patients). Risk of physical attacks was assessed by combining the 6-item BVC and a 6-point score derived from a Visual Analog Scale. Incidents were registered with the Staff Observation of Aggression Scale-Revised SOAS-R. Test accuracy was described as the area under the receiver operating characteristic curve (AUCROC).
The AUCROC of the new VAS-complemented BVC-version (BVC-VAS) was 0.95 in and 0.89 in the derivation and validation study respectively.
The BVC-VAS is an easy to use and accurate instrument for systematic short-term prediction of violent attacks in acute psychiatric wards. The inclusion of the VAS-derived data did not change the accuracy of the original BVC.
患者攻击行为是急性精神科病房常见问题，需要采取预防措施。及时采取预防措施的前提是预先进行风险评估。挪威的布罗泽特暴力检查表（BVC）是少数适用于常规护理中对精神科住院患者暴力行为进行短期预测的工具之一。我们研究的目的是通过将布罗泽特暴力检查表（BVC）与整体主观临床风险评估相结合，提高急性住院环境中暴力行为短期预测的准确性，并测试这种综合措施在日常实践中的应用。
我们进行了一项前瞻性队列研究，选取了两个新入院精神科患者样本，分别用于工具开发（219例患者）和临床应用（300例患者）。通过将6项BVC与视觉模拟量表得出的6分评分相结合，评估身体攻击的风险。事件通过工作人员攻击行为观察量表修订版（SOAS-R）进行记录。测试准确性用受试者工作特征曲线下面积（AUCROC）来描述。
新的VAS补充BVC版本（BVC-VAS）在推导研究和验证研究中的AUCROC分别为0.95和0.89。
BVC-VAS是一种易于使用且准确的工具，可用于系统地短期预测急性精神科病房中的暴力攻击行为。纳入VAS得出的数据并未改变原始BVC的准确性。
