Simmons Melanie, Maguire Tessa, Daffern Michael
Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Victoria, Australia.
Forensicare, Victorian Institute of Forensic Mental Health, Melbourne, Victoria, Australia.
J Psychiatr Ment Health Nurs. 2025 Apr;32(2):310-320. doi: 10.1111/jpm.13110. Epub 2024 Sep 20.
The Dynamic Appraisal of Situational Aggression (DASA) is used to appraise risk of imminent aggression in inpatient mental health settings.
We investigated whether individual patients' mean DASA scores over multiple consecutive time periods (a rolling DASA mean) improved predictive validity, beyond the ultimate DASA rating, and whether DASA ratings were associated with nursing intervention.
Archival data were analysed using cox regression analyses. We investigated the predictive validity of rolling DASA mean models and calculated how many daily DASA ratings generated a mean score with the best model fit. Chi-Squares with Odds Ratios were used to examine the effect of various aggression prevention intervention(s) on aggression means.
Daily DASA ratings had strong predictive validity. Incorporating the ultimate score with the rolling 10-day DASA mean slightly improved prediction. Limit setting was associated with an increased likelihood of aggression for low-risk patients whereas reassurance was associated with increased aggressiveness for those at increased risk of aggression.
Daily DASA ratings have strong predictive validity. Considering a 10-day rolling DASA mean in addition to the current day DASA rating may improve prediction.
DASA ratings can forecast imminent aggression. Additionally, there may be value in considering ratings from the previous 10 days.
情境性攻击动态评估（DASA）用于评估住院精神卫生环境中即将发生攻击行为的风险。
我们调查了个体患者在多个连续时间段内的平均DASA评分（滚动DASA均值）是否能提高预测效度（超过最终DASA评级），以及DASA评级是否与护理干预相关。
使用cox回归分析对存档数据进行分析。我们研究了滚动DASA均值模型的预测效度，并计算出多少天的DASA评级能产生与最佳模型拟合的平均分数。使用卡方检验和比值比来检验各种攻击预防干预措施对攻击均值的影响。
每日DASA评级具有很强的预测效度。将最终分数与滚动10天的DASA均值相结合可略微提高预测效果。对于低风险患者，设定限制与攻击行为增加的可能性相关；而对于攻击风险增加的患者，给予安慰与攻击性增加相关。
每日DASA评级具有很强的预测效度。除了当天的DASA评级外，考虑10天滚动DASA均值可能会提高预测效果。
DASA评级可以预测即将发生的攻击行为。此外，考虑前10天的评级可能会有价值。
