Citation

Abderhalden C, Needham I, Dassen TWN, Halfens R, Haug HJ, Fischer J. BMC Psychiatry 2006; 6: 17.

Affiliation

Nursing and Social Education Research Unit, University Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland. abderhalden@puk.unibe.ch

Copyright

(Copyright © 2006, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1471-244X-6-17

PMID

16638122

PMCID

PMC1459151

Abstract

BACKGROUND: Patient aggression is a common problem in acute psychiatric wards and calls for preventive measures. The timely use of preventive measures presupposes a preceded risk assessment. The Norwegian Brøset-Violence-Checklist (BVC) is one of the few instruments suited for short-time prediction of violence of psychiatric inpatients in routine care. Aims of our study were to improve the accuracy of the short-term prediction of violence in acute inpatient settings by combining the Brøset-Violence-Checklist (BVC) with an overall subjective clinical risk-assessment and to test the application of the combined measure in daily practice. METHOD: We conducted a prospective cohort study with two samples of newly admitted psychiatric patients for instrument development (219 patients) and clinical application (300 patients). Risk of physical attacks was assessed by combining the 6-item BVC and a 6-point score derived from a Visual Analog Scale. Incidents were registered with the Staff Observation of Aggression Scale-Revised SOAS-R. Test accuracy was described as the area under the receiver operating characteristic curve (AUCROC). RESULTS: The AUCROC of the new VAS-complemented BVC-version (BVC-VAS) was 0.95 in and 0.89 in the derivation and validation study respectively. CONCLUSION: The BVC-VAS is an easy to use and accurate instrument for systematic short-term prediction of violent attacks in acute psychiatric wards. The inclusion of the VAS-derived data did not change the accuracy of the original BVC.

Language: en