Chen Shing-Chia, Hwu Hai-Gwo
Department of Nursing, National Taiwan University College of Medicine, 1, Jen-Ai Road, Sec. 1, Taipei 100, Taiwan, ROC.
J Clin Nurs. 2009 Jul;18(13):1889-96. doi: 10.1111/j.1365-2702.2008.02669.x. Epub 2009 Jan 21.
The psychometric properties of the Chinese version of Violence Scale in clinical service setting were examined.
Psychiatric inpatient's aggressive act is a significant clinical issue in psychiatric service. A useful objective rating scale for prospective study and clinical application was mandatory.
A prospective panel study.
The Chinese version of Violence Scale developed from Morrison's Violence Scale. Sampled patients (n = 107) with schizophrenia spectrum, fulfilling the DSM-IV criteria, were recruited consecutively in a psychiatric acute ward of a university hospital over a period of one-year. The patients' counts of the aggressive acts measured by the Chinese version of Violence Scale occurred in the past one-month prior to admission and in the prospective initial-week after admission were collected during their hospitalisation. The prospective occurrence was observed daily and summed at a fixed weekly point. The internal consistency, content validity and predictive validity of the Chinese version of Violence Scale were examined. Also, a confirmatory factors analysis by LISREL was conducted to examine its measurement structure.
The Chinese version of Violence Scale follows a Poisson distribution of a fair quality (Cronbach's alpha = 0.67). The Chinese version of Violence Scale with panel's content validity has good predictive validity (r = 0.51, p < 0.001). Those correlated to one latent variable with six items, which constructs a core meaning of 'threatening aggression toward others'.
This panel study provides evidence for fair reliability and satisfactory validity of the Chinese version of Violence Scale. Internal consistency of the Chinese version of Violence Scale is limited and it may be because of the time-varying characteristic and hierarchical pattern of the behaviour items. To further investigate the count scale of the Chinese version of Violence Scale follows a Poisson distribution, the over-dispersion and weighting issues of aggressive acts were suggested to approach.
This study highlights the measurement issues and implications of the Chinese version of Violence Scale for objectively rating psychiatric patients' aggressive acts to further develop fitted nursing care and prevention program.
检验中文版暴力量表在临床服务环境中的心理测量特性。
精神科住院患者的攻击行为是精神科服务中的一个重要临床问题。需要一个用于前瞻性研究和临床应用的有效客观评定量表。
前瞻性小组研究。
中文版暴力量表由莫里森暴力量表改编而来。在一年时间里，连续招募了一所大学医院精神科急性病房中符合《精神疾病诊断与统计手册第四版》（DSM-IV）标准的107例精神分裂症谱系患者。在患者住院期间，收集他们在入院前一个月内以及入院后第一周前瞻性观察期内由中文版暴力量表测量的攻击行为次数。前瞻性观察每天进行，并在固定的每周时间点进行汇总。检验中文版暴力量表的内部一致性、内容效度和预测效度。此外，使用LISREL进行验证性因素分析以检验其测量结构。
中文版暴力量表呈质量尚可的泊松分布（克朗巴哈系数α = 0.67）。具有小组内容效度的中文版暴力量表具有良好的预测效度（r = 0.51，p < 0.001）。这些项目与一个包含六个条目的潜在变量相关，该潜在变量构建了“对他人的威胁性攻击”的核心含义。
该小组研究为中文版暴力量表具有尚可的信度和满意的效度提供了证据。中文版暴力量表的内部一致性有限，这可能是由于行为条目的时变特征和分层模式所致。为进一步研究中文版暴力量表计数量表是否呈泊松分布，建议探讨攻击行为的过度分散和加权问题。
本研究强调了中文版暴力量表在客观评定精神科患者攻击行为方面的测量问题及意义，以进一步制定合适的护理和预防方案。
