Risk of Psychiatric in-patient Violence: A Forensic Perspective
DOI:
https://doi.org/10.51253/pafmj.v74i4.11549Keywords:
Brøset violence checklist (BVC), Forensic psychiatry, violence, violent BehaviourAbstract
Objective: to assess the accuracy of Brøset violence checklist in predicting violence in psychiatric inpatients in a Pakistani setup.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Psychiatry, Mayo Hospital, Lahore Pakistan, from Mar to Sep 2021.
Methodology: One Hundred and Sixty-Seven patients from either gender, admitted to an acute psychiatric ward, were included in the study and their scoring was done. Socio-demographic information was collected from patients’ files, and violence data and preventive measures were recorded on the Staff Observation Aggression Scale-Revised form by nursing staff for three days. SOAS-R score of 9 or more was declared as a violent incident.
Results: Of the one hundred and sixty-seven patients, the mean age was 34.48±10.06 years. 109(65.3%) were males, and 58(34.7%)were females. Forty-nine episodes of violence were recorded. At a cutt off point of 2, Brøset violence checklist Sensitivity and Specificity were 69.4% and 92.4%, respectively. The corresponding PPV and NPV values were 79.1% and 92.4 %, respectively. ROC characteristics yielded an area under the curve of 0.86, showing good predictive accuracy.
Conclusion: Brøset violence checklist has good predictive accuracy for the prediction of imminent violence in a psychiatric setting in Pakistan.
Downloads
References
Girasek H, Nagy VA, Fekete S, Ungvari GS, Gazdag G. Prevalence and correlates of aggressive behavior in psychiatric inpatient populations. World J Psychiatr 2022; 12(1): 1–23.
https://doi.org/10.5498/wjp.v12.i1.1
Aguglia A, Belvederi-Murri M, Conigliaro C, Cipriani N, Vaggi M, Di Salvo G, et al. Workplace Violence and Burnout Among Mental Health Workers. Psychiatr Ser 2020; 71(3): 284–288.
https://doi.org/10.1176/appi.ps.201900161
Hilton NZ, Addison S, Ham E, Rodrigues N, Seto MC. Workplace violence and risk factors for PTSD among psychiatric nurses: Systematic review and directions for future research and practice. J Psychiatr Ment Health Nurs 2022; 29(2): 186-203.
https://doi.org/10.1111/jpm.12781
Lim E, Wynaden D, Heslop K. Changing practice using recovery-focused care in acute mental health settings to reduce aggression: A qualitative study. Int J Ment Health Nurs 2018; 28(1): 237–246. https://doi.org/10.1111/inm.12524
Bjorkdahl A, Olsson D, Palmstierna T. Nurses’ short-term prediction of violence in acute psychiatric intensive care. Acta Psychiatrica Scandinavica 2006; 113(3): 224–229.
https://doi.org/10.1111/j.1600-0447.2005.00679.x
Yao X, Shao J, Wang L, Zhang J, Zhang C, Lin Y. Does workplace violence, empathy, and communication influence occupational stress among mental health nurses? Int J Ment Health Nurs 2021; 30(1): 177-188. https://doi.org/10.1111/inm.12770
Hassan T, Nizami AT, Asmer MS. Forensic psychiatric service provision in Pakistan and its challenges. BJPsych International. 2017; 14(2): 40–44. https://doi.org/10.1192/s205647400000177x
Weltens I, Bak M, Verhagen S, Vandenberk E, Domen P, van Amelsvoort T, et al. Aggression on the Psychiatric ward: Prevalence and Risk factors. a Systematic Review of the Literature. Didden R, editor. PLoS One 2021; 16(10): e0258346.
https://doi.org/10.1371/journal.pone.0258346
Nyman M, Hofvander B, Nilsson T, Wijk H. Mental Health Nurses’ Experiences of Risk Assessments for Care Planning in Forensic Psychiatry. Int J Forensic Ment Health 2019; 19(2): 103–113. https://doi.org/10.1080/14999013.2019.1646356
Marques MI, Bessa A, Santos L, Carvalho S, Neves G. Assessment of the Risk of Violence in Portuguese Psychiatric Settings Using the Brøset Violence Checklist. Sociol Stud 2015; 5(5). https://doi.org/10.17265/2159-5526/2015.05.004
Kocabiyik N, Yildirim S, Turgut EO, Kayaci-Turk M, Ayer A. A study on the frequency of violence to healthcare professionals in a mental health hospital and related factors. Dusunen Adam J Psychiatr Neurol Sci 2015; 28(2): 112.
https://doi.org/10.5350/DAJPN2015280203
Yao X, Li Z, Arthur D, Hu L, An F-R, Cheng G. Acceptability and psychometric properties of Brøset Violence Checklist in psychiatric care settings in China. J Psychiatr Ment Health Nurs 2014; 21(9): 848-855. https://doi.org/10.1111/jpm.12132
Clarke DE, Brown AM, Griffith P. The Brøset Violence Checklist: clinical utility in a secure psychiatric intensive care setting. J Psychiatr Ment Health Nurs 2010; 17(7): 614–620.
https://doi.org/10.1111/j.1365-2850.2010.01558.x
Steadman HJ, Silver E, Monahan J, Appelbaum PS, Clark-Robbins P, Mulvey EP, et al. A classification tree approach to the development of actuarial violence risk assessment tools. Law Human Behav 2000; 24(1): 83–100.
https://doi.org/10.1023/a:1005478820425
Almvik R, Woods P, Rasmussen K. The Brøset Violence Checklist. J Interperson Violence 2000; 15(12): 1284–1296.
https://doi.org/10.1177/0886260000150120
Hvidhjelm J, Sestoft D, Skovgaard LT, Bue Bjorner J. Sensitivity and specificity of the Brøset Violence Checklist as predictor of violence in forensic psychiatry. Nordic J Psychiatr 2014; 68(8): 536–542. https://doi.org/10.3109/08039488.2014.880942
Partridge B, Affleck J. Predicting aggressive patient behaviour in a hospital emergency department: An empirical study of security officers using the Brøset Violence Checklist. Aust Emerg Care 2018; 21(1): 31–35.
https://doi.org/10.1016/j.auec.2017.11.001
Abderhalden C, Needham I, Miserez B, Almvik R, Dassen T, Haug HJ, et al. Predicting inpatient violence in acute psychiatric wards using the Broset-Violence-Checklist: a multicentre prospective cohort study. J Psychiatr Ment Health Nursing. 2004; 11(4): 422–427.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Sadaat Ibrahim, Mariam Arif, Arif Rasheed Malik, Shahzad Shafiq
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.