Abderhalden Christoph, Needham Ian, Dassen Theo, Halfens Ruud, Haug Hans-Joachim, Fischer Joachim E
Nursing and Social Education Research Unit, University Bern Psychiatric Services, Bolligenstrasse 111, Berne 60, Switzerland.
Br J Psychiatry. 2008 Jul;193(1):44-50. doi: 10.1192/bjp.bp.107.045534.
There is a lack of research on the possible contribution of a structured risk assessment to the reduction of aggression in psychiatric in-patient care.
To assess whether such risk assessments decrease the incidence of violence and coercion.
A cluster randomised controlled trial was conducted with 14 acute psychiatric admission wards as the units of randomisation, including a preference arm. The intervention comprised a standardised risk assessment following admission with mandatory evaluation of prevention in high-risk patients.
Incidence rates decreased substantially in the intervention wards, whereas little change occurred in the control wards. The adjusted risk ratios suggest a 41% reduction in severe aggressive incidents and a 27% decline in the use of coercive measures. The severity of aggressive incidents did not decrease.
Structured risk assessment during the first days of treatment may contribute to reduced violence and coercion in acute psychiatric wards.
关于结构化风险评估对减少精神科住院治疗中攻击行为的可能作用，目前缺乏相关研究。
评估此类风险评估是否能降低暴力和强制手段的发生率。
以14个急性精神科入院病房作为随机分组单位进行整群随机对照试验，包括一个偏好组。干预措施包括入院后进行标准化风险评估，并对高危患者进行预防措施的强制评估。
干预病房的发生率大幅下降，而对照病房变化不大。调整后的风险比表明，严重攻击事件减少了41%，强制手段的使用减少了27%。攻击事件的严重程度并未降低。
治疗初期的结构化风险评估可能有助于减少急性精神科病房中的暴力和强制行为。
