Centre for Applied Nursing Research, Western Sydney University and South West Sydney Local Health District, Ingham Institute for Medical Research, 1 Campbell Street, Liverpool, NSW 2170, Australia.
Centre for Applied Nursing Research, Western Sydney University and South West Sydney Local Health District, Ingham Institute for Medical Research, 1 Campbell Street, Liverpool, NSW 2170, Australia.
Int J Nurs Stud. 2020 Apr;104:103526. doi: 10.1016/j.ijnurstu.2020.103526. Epub 2020 Jan 11.
Structured risk assessment schemes can aid violence reduction in mental health and correctional settings. However, the properties and effectiveness of schemes for predicting imminent (within 24-h) violence have not been comprehensively reviewed.
To systematically review the properties and predictive performance of structured schemes that have been used to predict imminent aggression.
Systematic review and meta-analysis.
Multiple electronic databases were searched, relevant reference lists and journals were hand-searched.
Thirty-two structured risk assessment schemes were identified and used in a search for evidence about the prediction of imminent violence, or their psychometric properties when used for that purpose. Study findings were synthesised narratively and, where statistics about predictive validity were available, subjected to meta-analyses.
Five schemes (Brøset Violence Checklist, HCR-20: Assessing Risk for Violence version 2.0 clinical subscale, Dynamic Appraisal of Situational Aggression and its variants for youth and for women) have been subject to relevant research. Fifty papers were included in a narrative review, and 31 comprising 26 samples involving 282,238 assessments for 2723 individuals were included in meta-analyses. Only the Dynamic Appraisal of Situational Aggression and the Brøset Violence Checklist were subject to implementation research in which the tools were largely rated as having utility for, and being acceptable to, user-participants. Many studies have not established interrater reliability of the tools in the field. After removing outliers, pooled effect sizes for prediction of aggression against people and for any aggression were, respectively: Hedges' g = 1.35[1.15-1.56]) and g = 1.24[0.99, 1.50] for the Brøset Violence Checklist and g = 1.04 [0.69, 1.39] and 0.88 [0.62, 1.15] for the Dynamic Appraisal of Situational Aggression. Moderator analyses revealed pooled effect sizes for both schemes were decreased by low study bias risk and increased by patient forensic vs. civil legal status.
Research supports the value of both the Brøset Violence Checklist and the Dynamic Appraisal of Situational Aggression. Both are generally acceptable and feasible to implement, and their predictive value is broadly equivalent producing large pooled effect sizes. There is less evidence about the Dynamic Appraisal of Situational Aggression. variants for women and youth though initial studies are promising.
结构化风险评估方案可以帮助减少精神健康和矫正环境中的暴力行为。然而，预测即将发生（24 小时内）暴力的方案的性质和有效性尚未得到全面审查。
系统回顾用于预测即将发生的攻击行为的结构化方案的性质和预测性能。
系统评价和荟萃分析。
多个电子数据库进行了搜索，相关的参考文献和期刊进行了手工搜索。
确定了 32 种结构化风险评估方案，并用于搜索有关预测即将发生的暴力行为的证据，或在为此目的使用时的心理测量特性。综合叙述了研究结果，并且在有预测有效性统计数据的情况下，对其进行了荟萃分析。
五种方案（Brøset 暴力清单、HCR-20：评估暴力风险 2.0 临床量表、动态评估情境攻击及其针对青年人和妇女的变体）已经进行了相关研究。50 篇论文进行了叙述性综述，31 篇论文包括 26 个样本，涉及 282238 次评估，涉及 2723 个人，纳入荟萃分析。只有动态评估情境攻击和 Brøset 暴力清单进行了实施研究，研究结果表明这些工具在很大程度上被认为具有实用性，并且得到了用户参与者的认可。许多研究并未在现场确定工具的评分者间信度。在剔除离群值后，针对人际攻击和任何攻击的预测的汇总效应大小分别为：Hedges'g=1.35[1.15-1.56])和 g=1.24[0.99, 1.50]）和 Brøset 暴力清单的 g=1.04 [0.69, 1.39]和 0.88 [0.62, 1.15]）和动态评估情境攻击的 g=1.04 [0.69, 1.39]。 荟萃分析显示，两种方案的汇总效应大小都因研究偏倚风险较低而增加，因患者的法医与民事法律地位而异。
研究支持 Brøset 暴力清单和动态评估情境攻击的价值。两者通常都是可以接受的和可行的实施，其预测价值是相当的，产生了较大的汇总效应大小。关于动态评估情境攻击的证据较少。尽管初步研究有希望，但针对妇女和青年的变体。
