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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

Vaaler, Arne; Iversen, Valentina Cabral; Morken, Gunnar; Fløvig, John Chr.; Palmstierna, Tom; Linaker, Olav Morten
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/302174
Date
2011
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  • Institutt for nevromedisin og bevegelsesvitenskap [1657]
  • Publikasjoner fra CRIStin - NTNU [19961]
Original version
BMC Psychiatry 2011, 11(44)   10.1186/1471-244X-11-44
Abstract
Background: The 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.

Methods: In 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.

Results: The 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.

Conclusions: In 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.
Publisher
BioMed Central
Journal
BMC Psychiatry

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