Department of Health, Utrecht University of Applied Science, Utrecht, The Netherlands.
GGnet Mental Health Centre, GGnet, Warnsveld, The Netherlands.
Int J Ment Health Nurs. 2017 Oct;26(5):423-436. doi: 10.1111/inm.12381.
Findings from an increasing number of studies suggest that incorporating systematic short-term risk assessments in treatment planning could lead to safer practice on psychiatric admissions wards. The aim of the present study was to investigate the associations between the scores of three structured observation tools - the Kennedy Axis V (K-Axis-V), the Brief Psychiatric Rating Scale (BPRS), and the Social Dysfunction and Aggression Scale (SDAS) - and seclusion. In total, 1840 weekly risk assessments with these observation scales were collected over 2342 admission weeks. These assessment scores related to 370 acutely-admitted psychiatric patients and were subjected to a multilevel analysis. It was found that several dynamic and static factors were related to seclusion. Dynamic factors included violent behaviour, current substance abuse, suspiciousness, and negativism. Static factors included ethnicity and having been diagnosed with a substance abuse disorder. The findings suggest that the incorporation of the Kennedy-Axis V, the BPRS, and the SDAS into standard practice might be helpful in identifying patients at high risk of seclusion, and could be supportive to treatment planning and clinical decision-making in the prevention of seclusion use in acute psychiatric settings.
越来越多的研究结果表明，在治疗计划中纳入系统的短期风险评估可能会导致精神科住院病房的治疗更为安全。本研究旨在探讨三种结构化观察工具（肯尼迪轴 V 量表（K-Axis-V）、简明精神病评定量表（BPRS）和社会功能障碍和攻击量表（SDAS））的评分与隔离之间的关联。共收集了 2342 个住院周的 1840 次每周风险评估，这些评估评分涉及 370 名急性入院的精神科患者，并进行了多层次分析。结果发现，一些动态和静态因素与隔离有关。动态因素包括暴力行为、当前物质滥用、怀疑和消极态度。静态因素包括种族和被诊断为物质滥用障碍。研究结果表明，将 Kennedy-Axis V、BPRS 和 SDAS 纳入标准实践可能有助于识别有高隔离风险的患者，并为急性精神科环境中隔离使用的预防提供治疗计划和临床决策支持。
