Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics

BMC Psychiatry

Research Article

Arne E Vaaler¹  Olav M Linaker¹  John C Fløvig²  Valentina C Iversen²  Gunnar Morken²  Tom Palmstierna³ 

[1] Department of Neuroscience, Faculty of Medicine, Norwegian, University of Science and Technology, Trondheim, Norway;Division of Psychiatry, Department of Research and Development, St Olavs University Hospital, Trondheim, Norway;Department of Neuroscience, Faculty of Medicine, Norwegian, University of Science and Technology, Trondheim, Norway;Division of Psychiatry, Department Østmarka, St Olavs University Hospital, Trondheim, Norway;Department of Neuroscience, Faculty of Medicine, Norwegian, University of Science and Technology, Trondheim, Norway;Social and Forensic Psychiatry Program, Stockholm Centre for Psychiatric Research and Education, Karolinska Institutet/Stockholm County Council Health Care Provision, Stockholm, Sweden;Forensic Dept. and Research Centre Brøset, St. Olav's University Hospital, Trondheim, Norway;

关键词: Schizophrenia;    Brief Psychiatric Rate Scale;    Psychiatric Inpatient;    Violent Incident;    Involuntary Admission;   

DOI  :  10.1186/1471-244X-11-44

 received in 2010-08-22, accepted in 2011-03-18,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe aims of the present study were to investigate clinically relevant patient and environment-related predictive factors for threats and violent incidents the first three days in a PICU population based on evaluations done at admittance.MethodsIn 2000 and 2001 all 118 consecutive patients were assessed at admittance to a Psychiatric Intensive Care Unit (PICU). Patient-related conditions as actuarial data from present admission, global clinical evaluations by physician at admittance and clinical nurses first day, a single rating with an observer rated scale scoring behaviours that predict short-term violence in psychiatric inpatients (The Brøset Violence Checklist (BVC)) at admittance, and environment-related conditions as use of segregation or not were related to the outcome measure Staff Observation Aggression Scale-Revised (SOAS-R). A multiple logistic regression analysis with SOAS-R as outcome variable was performed.ResultsThe global clinical evaluations and the BVC were effective and more suitable than actuarial data in predicting short-term aggression. The use of segregation reduced the number of SOAS-R incidents.ConclusionsIn a naturalistic group of patients in a PICU segregation of patients lowers the number of aggressive and threatening incidents. Prediction should be based on clinical global judgment, and instruments designed to predict short-term aggression in psychiatric inpatients.Trial registrationsNCT00184119/NCT00184132

【 授权许可】

CC BY   
© Vaaler et al; licensee BioMed Central Ltd. 2011