Yao X, Li Z, Arthur D, Hu L, An F-R, Cheng G
School of Nursing, Peking Union Medical College, Beijing, China.
J Psychiatr Ment Health Nurs. 2014;21(9):848-55. doi: 10.1111/jpm.12132. Epub 2014 Feb 19.
Short-term risk assessment instrument owns great importance for psychiatric nurses in China; however, the lack of a standardized violence risk assessment instrument has disadvantaged them in clinical practice. The Brøset Violence Checklist (BVC), a behavioural observation tool, is the most frequently cited instrument available for evaluating violence risk in psychiatric inpatients, then worth to be tested in Chinese culture. This study, conducted in two closed wards in a psychiatric hospital in Beijing, revealed that the instrument has favourable reliability, validity and predictive accuracy in Chinese population. BVC provides nurses with a quick and easily administered method to screening out patients with violence potential, thus allowing for early intervention. Feedback from the nurses was quite encouraging and the further use of BVC seems promising. The lack of standardized violence risk assessment instrument has disadvantaged nurses in clinical practice in China, where violent behaviour is an increasing problem. This study conducted a validation of the Brøset Violence Checklist that has proven effective in violence risk prediction in other countries. A sample of 296 patients consecutively admitted to two wards of a psychiatric hospital in Beijing was recruited. These patients were assessed on day shift and evening shift for the first seven days of hospitalization. Violence data and preventive measures were concurrently collected from nursing records and case reports. A total of 3707 assessments for 281 patients were collected revealing 93 episodes of violence among 55 patients. Receiver operating characteristics yielded an area under the curve of 0.85. At the cut-off point of one, its sensitivity/specificity was 78.5%/88.2% and the corresponding positive/negative predictive value was 14.6%/99.4%. In some false positive cases, intense preventive measures had been implemented. Positive feedback from the nurses was gained. The Brøset Violence Checklist was proved as an easy-to-use and time-saving instrument, therefore, regarded as a promising tool to determine if the psychiatric users are potentially violent in the short term.
短期风险评估工具对中国精神科护士非常重要；然而，缺乏标准化的暴力风险评估工具使他们在临床实践中处于不利地位。布罗泽特暴力清单（BVC）是一种行为观察工具，是评估精神科住院患者暴力风险时最常被引用的工具，因此值得在中国文化背景下进行测试。本研究在北京一家精神病医院的两个封闭病房进行，结果显示该工具在中国人群中具有良好的信度、效度和预测准确性。BVC为护士提供了一种快速且易于实施的方法，以筛查出有暴力倾向的患者，从而实现早期干预。护士们的反馈相当令人鼓舞，BVC的进一步应用前景似乎很广阔。在中国，暴力行为问题日益严重，缺乏标准化的暴力风险评估工具使护士在临床实践中处于不利地位。本研究对布罗泽特暴力清单进行了验证，该清单在其他国家已被证明在暴力风险预测方面有效。研究招募了北京一家精神病医院两个病房连续收治的296例患者。这些患者在住院的前七天接受日班和夜班评估。同时从护理记录和病例报告中收集暴力数据和预防措施。共收集了对281例患者的3707次评估，发现55例患者中有93次暴力事件。受试者工作特征曲线下面积为0.85。在截断值为1时，其灵敏度/特异度为78.5%/88.2%，相应的阳性/阴性预测值为14.6%/99.4%。在一些假阳性病例中，已经实施了强化预防措施。获得了护士们的积极反馈。布罗泽特暴力清单被证明是一种易于使用且节省时间的工具，因此，被视为一种有前景的工具，用于确定精神科患者短期内是否有潜在暴力行为。
