School of Nursing, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
Int J Nurs Stud. 2014 Feb;51(2):198-207. doi: 10.1016/j.ijnurstu.2013.06.002. Epub 2013 Jul 5.
A standard measure to assess and predict violence is important for psychiatric services. No prospective study has examined the history of violence and heterogeneity of violence in predicting specific types of violence among inpatient with schizophrenia.
This study aimed to prospectively examine the accuracy of prediction of types of violence using the Chinese modified version of Violence Scale (VS-CM) among inpatients with schizophrenia based on their past history of violence and the real occurrence of violence during hospitalization.
A prospective cohort study design.
A total of 107 adult patients with schizophrenia spectrum disorders, consecutively admitted to an acute psychiatric ward of a university hospital in Taiwan, were recruited.
In addition to data about demographics and clinical illness, count records of the history of violence within one month prior to admission by interview and the actual occurrence of violence during the whole course of hospitalization by participant observation were collected using the VS-CM. Multivariate logistic analysis and area under the Receiver Operating Characteristic curve (AUC) analysis were applied to examine the predictive ability of the VS-CM.
A patient's history of violence assessed by the VS-CM predicted the actual occurrence of violence during hospitalization with the Odds Ratio of 17.5 (p=0.001). The predictive accuracy of the VS-CM had high sensitivity (97.0%), moderate positive predictive value (71.4%), and high negative predictive value (87.5%); however, the specificity was relatively low (35.0%). The AUC was 79.5% using the total scale of the VS-CM and 70.7-74.5% using the subscales in predicting corresponding types of violence.
The VS-CM is a valid and reliable measure of potential violence. It can be applied to assess and predict specific types of violence among inpatient with schizophrenia.
评估和预测暴力的标准方法对于精神科服务非常重要。目前还没有前瞻性研究检查过暴力史和暴力异质性在预测精神分裂症住院患者特定类型暴力中的作用。
本研究旨在前瞻性地检查基于过去暴力史和住院期间实际发生的暴力，使用中文版暴力量表（VS-CM）预测精神分裂症住院患者特定类型暴力的准确性。
前瞻性队列研究设计。
共招募了 107 名成年精神分裂症谱系障碍患者，他们连续入住台湾一家大学医院的急性精神科病房。
除了人口统计学和临床疾病数据外，还通过访谈收集入院前一个月内的暴力史记录，并通过参与者观察收集整个住院期间的实际暴力发生情况，使用 VS-CM 进行评估。应用多元逻辑回归分析和受试者工作特征曲线（ROC）下面积（AUC）分析来评估 VS-CM 的预测能力。
VS-CM 评估的患者暴力史预测了住院期间实际发生的暴力，优势比为 17.5（p=0.001）。VS-CM 的预测准确性具有较高的敏感性（97.0%）、中度阳性预测值（71.4%）和高阴性预测值（87.5%）；然而，特异性相对较低（35.0%）。使用 VS-CM 的总分预测相应类型暴力的 AUC 为 79.5%，使用子量表的 AUC 为 70.7-74.5%。
VS-CM 是一种有效且可靠的潜在暴力评估工具。它可以用于评估和预测精神分裂症住院患者特定类型的暴力。
