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短期风险评估的长期预测:布罗塞特暴力检查表的范围综述和荟萃分析。

Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset Violence Checklist.

机构信息

Clinical Mental Health and Nursing Research Unit, Mental Health Center, Sct Hans, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.

Psychiatric Research Unit, Centre for Relation & De-escalation, Mental Health Services, Region Zealand, Denmark.

出版信息

J Psychiatr Ment Health Nurs. 2023 Aug;30(4):637-648. doi: 10.1111/jpm.12905. Epub 2023 Feb 11.

DOI:10.1111/jpm.12905
PMID:36718598
Abstract

UNLABELLED

WHAT IS KNOWN ON THE SUBJECT?: The Brøset Violence Checklist (BVC) has been widely translated and implemented in diverse mental healthcare settings to improve prevention of violence. It is valued as a brief but effective tool in clinical practice. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the largest and most comprehensive international review of the BVC conducted in the 25+ years since the inception of the instrument in 1995. It integrates findings from existing studies and establishes that the tool has many impressive strengths considering the brief time investment required for completion. The review reveals that the tool has been used in more than 20 different countries around the world in a variety of mental health and other settings as both a risk assessment tool to guide clinical practice and as a formally structured intervention to minimize violence. There is much variation in how the tool is implemented and scored in different services. This variation questions its applicability as a resource and consistency and its use needs attention. This variation in use also limits the conclusions regarding best practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The review supports the use of the BVC as one part of the package for mental health services committed to preventive action aimed at reducing violence and coercion. The review identified that the patient perspective was often absent when completing the BVC, and so this should be considered as an option by services as part of a collaborative philosophy of care.

ABSTRACT

INTRODUCTION: Existing literature on the Brøset Violence Checklist (BVC) is examined in the context of usability, implementation and validity to provide evidence-based recommendations on its application and identify opportunities for future development.

AIM/QUESTION: To identify current knowledge on the BVC and guide clinicians and researchers toward the next steps in using this tool in clinical practice to prevent violence in healthcare settings.

METHOD

A scoping review approach with a meta-analysis supplement was adopted to broadly identify and map available evidence on the BVC and provide specific estimates of predictive validity in different contexts.

RESULTS

Sixty-two studies conducted in 23 countries addressed the implementation of the BVC across various settings. Many studies adapted the original BVC, and the clinical utility was noted as an important feature. A meta-analysis of the original BVC format estimated a pooled area under the curve at 0.83 (95% CI 0.78-0.87) in a subset of 15 studies.

DISCUSSION

The BVC combines high predictive validity and good clinical utility across a wide range of settings and cultures. It should continue to be incorporated into routine practice in mental health services focused on preventing violence and coercion.

IMPLICATIONS FOR PRACTICE

Development of collaborative approaches with service users involved in assessing their own risk of future violence.

摘要

目的

在可用性、实施和有效性的背景下检查 Brøset 暴力检查表(BVC)的现有文献,为其应用提供循证建议,并确定未来发展的机会。

方法

采用范围综述方法,并辅以荟萃分析,广泛确定和绘制 BVC 的现有证据,并提供不同背景下预测有效性的具体估计。

结果

62 项在 23 个国家开展的研究探讨了 BVC 在各种环境下的实施情况。许多研究对原始 BVC 进行了改编,并指出临床实用性是一个重要特征。对原始 BVC 格式的荟萃分析估计,在 15 项研究的一个子集中,汇总曲线下面积为 0.83(95%CI 0.78-0.87)。

讨论

BVC 在广泛的设置和文化中结合了高预测有效性和良好的临床实用性。它应该继续纳入专注于预防暴力和强制的精神卫生服务的常规实践。

结论

与参与评估自己未来暴力风险的服务使用者合作制定方法。

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