Citation

Simmons ML, Maguire T, Ogloff JRP, Gabriel J, Daffern M. J. Psychiatr. Ment. Health Nurs. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, John Wiley and Sons)

DOI

10.1111/jpm.12913

PMID

36825355

Abstract

INTRODUCTION: The Dynamic Appraisal of Situational Aggression (DASA) is an inpatient aggression risk assessment instrument. Recently, research explored whether the unit atmosphere, as indicated by a unit's average DASA score, was related to inpatient aggression risk, but failed to control for individual risk.

AIM: Investigate whether the DASA unit average score or an interaction between the unit average and an individual patient's DASA score was related to the likelihood that an individual would act aggressively.

METHOD: Cox regression with repeated assessments and recurrent events was used to analyse 11,243 DASA risk assessments of 113 inpatients collected via retrospective file review.

RESULTS: The unit DASA average score was not related to aggression towards staff. There was a negative interaction between the individual and the unit DASA average scores when identifying patient-to-patient aggression; high-risk patients engaged in less aggression when the unit average was heightened relative to units with lower DASA average scores.

DISCUSSION: It is possible that there were more nursing interventions and/or patients engaged in greater self-regulation on unsettled units, thus reducing aggression. IMPLICATIONS FOR PRACTICE: Currently, there is insufficient evidence to suggest that the unit average score should be used to supplement individual DASA scores to identify aggression risk.

Language: en

Keywords

risk assessment; aggression; acute mental health; forensic