Väätäinen Laura, Björkqvist Maiju, Li Yan, Pelto-Piri Veikko, Ferreira António, Lantta Tella
Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.
School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
Int J Ment Health Nurs. 2025 Jul;34(4):e70110. doi: 10.1111/inm.70110.
Short-term (24 h) violence risk assessment and management can reduce violence in institutional settings, yet they remain understudied in adolescent populations. This systematic review aimed to identify instruments used for short-term violence risk assessment and strategies for managing violence risk among adolescents in institutional settings, as well as to evaluate related outcomes. PRISMA was used as an evidence-based minimum set of items for reporting systematic reviews. The literature search (March 2024 and March 2025) was conducted in PubMed, PsycINFO, Web of Science, CINAHL, The Cochrane Library and Scopus, and references from selected studies were reviewed. Data extraction and analysis were performed in Covidence. Nine studies met inclusion criteria describing six assessment instruments: DASA, DASA-YV, V-RISK-Y, Kennedy Axis V, Pedi-BEWS and BVC. No studies regarding strategies for short-term violence risk management were identified. DASA-YV, BVC and V-RISK-Y predicted violence among adolescents within 24 h (AUC = 0.70-0.95); DASA predicted violence moderately (AUC = 0.50-0.69). Pedi-BEWS (ICC = 0.83) and Kennedy Axis V (ICC = 0.79) demonstrated similar inter-rater reliability. Due to the lack of studies, firm conclusions on the best instrument for clinical practice in institutional settings remained elusive. Further research is necessary to ascertain if youth-specific instruments (e.g., DASA-YV, V-RISK-Y) predict violence more effectively than non-age-specific instruments (e.g., DASA). The lack of youth engagement in violence risk assessment stands out clearly. Scoring was done by the staff, mostly by nurses. Future studies should involve adolescents in the scoring or evaluation of assessment and management. There is a need for evidence-based recommendations for youth engagement.
短期（24小时）暴力风险评估与管理能够减少机构环境中的暴力行为，但在青少年群体中仍未得到充分研究。本系统评价旨在确定用于机构环境中青少年短期暴力风险评估的工具以及管理暴力风险的策略，并评估相关结果。PRISMA被用作报告系统评价的基于证据的最低项目集。文献检索（2024年3月至2025年3月）在PubMed、PsycINFO、科学网、CINAHL、考克兰图书馆和Scopus中进行，并对所选研究的参考文献进行了审查。数据提取和分析在Covidence中进行。九项研究符合纳入标准，描述了六种评估工具：DASA、DASA-YV、V-RISK-Y、肯尼迪轴V、儿童预警评分（Pedi-BEWS）和暴力风险分类（BVC）。未发现有关短期暴力风险管理策略的研究。DASA-YV、BVC和V-RISK-Y预测了24小时内青少年的暴力行为（曲线下面积[AUC]=0.70-0.95）；DASA对暴力行为的预测为中等程度（AUC=0.50-0.69）。儿童预警评分（组内相关系数[ICC]=0.83）和肯尼迪轴V（ICC=0.79）显示出相似的评分者间信度。由于缺乏研究，对于机构环境中临床实践的最佳工具仍难以得出确凿结论。有必要进行进一步研究，以确定针对青少年的工具（如DASA-YV、V-RISK-Y）是否比非特定年龄的工具（如DASA）更有效地预测暴力行为。青少年在暴力风险评估中的参与度明显不足。评分由工作人员进行，主要是护士。未来的研究应让青少年参与评估和管理的评分或评估。需要基于证据的关于青少年参与的建议。
