Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics 英文参考文献.docVIP

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Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics 英文参考文献.doc

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

Vaaleretal.BMCPsychiatry2011,11:44 /1471-244X/11/44 RESEARCH ARTICLE OpenAccess Short-termpredictionofthreateningandviolent behaviourinanAcutePsychiatricIntensiveCare Unitbasedonpatientandenvironment characteristics ArneEVaaler1,2*,ValentinaCIversen1,3,GunnarMorken1,3,JohnCFl?vig1,3,TomPalmstierna1,4,5,OlavMLinaker1,2 Abstract Background:Theaimsofthepresentstudyweretoinvestigateclinicallyrelevantpatientandenvironment-related predictivefactorsforthreatsandviolentincidentsthefirstthreedaysinaPICUpopulationbasedonevaluations doneatadmittance. Methods:In2000and2001all118consecutivepatientswereassessedatadmittancetoaPsychiatricIntensive CareUnit(PICU).Patient-relatedconditionsasactuarialdatafrompresentadmission,globalclinicalevaluationsby physicianatadmittanceandclinicalnursesfirstday,asingleratingwithanobserverratedscalescoringbehaviours thatpredictshort-termviolenceinpsychiatricinpatients(TheBr?setViolenceChecklist(BVC))atadmittance,and environment-relatedconditionsasuseofsegregationornotwererelatedtotheoutcomemeasureStaff ObservationAggressionScale-Revised(SOAS-R).AmultiplelogisticregressionanalysiswithSOAS-Rasoutcome variablewasperformed. Results:TheglobalclinicalevaluationsandtheBVCwereeffectiveandmoresuitablethanactuarialdatain predictingshort-termaggression.TheuseofsegregationreducedthenumberofSOAS-Rincidents. Conclusions:InanaturalisticgroupofpatientsinaPICUsegregationofpatientslowersthenumberofaggressive andthreateningincidents.Predictionshouldbebasedonclinicalglobaljudgment,andinstrumentsdesignedto predictshort-termaggressioninpsychiatricinpatients. Trialregistrations:NCNCBackground predictions in different psychiatric settings have been Threateningandviolentbehaviourbypsychiatricinpati- extensivelydescribed[5]. ents are major concerns in psychiatric practice [1,2]. InPsychiatricIntensiveCareUnits(PICUs)andemer- Aggression has negative consequences for patients and gencyservicesviolentincidentsarefrequ