Arenas Vera, Muñoz Estibaliz, Barroeta Amaia, Oreja Marisa, Aguirre Urko, Erkoreka Leire
Department of Psychiatry, Galdakao-Usansolo University Hospital Osakidetza Basque Health Service, Galdakao, Spain.
Research Unit, Galdakao-Usansolo University Hospital Osakidetza Basque Health Service, Galdakao, Spain.
J Psychiatr Ment Health Nurs. 2025 Aug;32(4):975-985. doi: 10.1111/jpm.13176. Epub 2025 Apr 12.
The management of violence and restrictive practices in acute mental health units poses a challenge for the design of clinical nursing protocols that combine the safety of professionals and the dignified care of patients. Many of the strategies aimed at reducing seclusion and restraint practices include the use of standardised risk assessment instruments, preferably conducted by the nursing staff. Among them, the Brøset Violence Checklist (BVC) is one of the most widely supported tools.
To conduct the Spanish validation of the BVC and to explore its predictive validity for violence and for the use of restraint.
Prospective data from 115 patients consecutively admitted to an acute unit of a general university hospital were gathered to validate the instrument. The role of risk factors for violence such as gender, age, substance use or the involuntariness of the admission was analysed, both in relation to the BVC score and to the need for physical restraint in the short and middle term (72 h and 1 week).
The Spanish version of the BVC maintains its predictive validity for imminent violence and guarantees excellent inter-rater reliability among mental health nurses. The score in the first shift after admission is significantly associated with increased odds of restraint at 72 h (OR = 7.272), and age with decreased odds (OR = 0.903), with no significant effect of the rest of the variables.
The BVC is a reliable tool that seems to capture the risk for violence intrinsic to other factors, such as the involuntariness of admission. Its role in the design of non-restraint policies is discussed.
BVC is a useful and freely available instrument. Its Spanish version opens up its use in the fourth most widely spoken language.
在急性精神卫生病房中，暴力行为及限制措施的管理对临床护理方案的设计构成挑战，这类方案需兼顾专业人员的安全和对患者的尊严护理。许多旨在减少隔离和约束措施的策略包括使用标准化风险评估工具，最好由护理人员进行。其中，布罗泽特暴力检查表（BVC）是最受广泛支持的工具之一。
对BVC进行西班牙语版本的验证，并探讨其对暴力行为及约束措施使用的预测效度。
收集一所综合大学医院急性病房连续收治的115例患者的前瞻性数据以验证该工具。分析暴力风险因素的作用，如性别、年龄、物质使用情况或入院的非自愿性，涉及BVC评分以及短期和中期（72小时和1周）身体约束的需求。
BVC的西班牙语版本对即将发生的暴力行为保持其预测效度，并保证精神科护士之间具有出色的评分者间信度。入院后第一个班次的评分与72小时时约束几率增加显著相关（比值比[OR]=7.272），年龄与约束几率降低相关（OR=0.903），其他变量无显著影响。
BVC是一种可靠的工具，似乎能捕捉到其他因素（如入院的非自愿性）所固有的暴力风险。讨论了其在无约束政策设计中的作用。
BVC是一种有用且免费可得的工具。其西班牙语版本使其能在使用第四广泛的语言环境中得以应用。
