心理健康住院患者的暴力风险预测,使用情境侵略的动态评估
Mario Moscovici1, Farhat Farrokhi1, Lavanya Vangala1
1Forensic Psychiatry Division, The Centre for Addiction and Mental Health, Toronto, ON, Canada.
Frontiers in psychiatry
|December 25, 2024
概括
情境性攻击的动态评估 (DASA) 工具有效地预测了精神病单位的暴力风险. 新的风险类别可以识别从干预中受益的患者,提高工作人员和患者的安全.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 医疗保健安全 医疗保健安全
背景情况:
- 侵略和暴力在医疗机构中构成重大风险,影响患者和工作人员.
- 情境性侵略的动态评估 (DASA) 是一种现有的工具,用于评估短期住院患者的侵略风险.
- 缺乏DASA在各种临床环境中的大规模验证.
研究的目的:
- 评估DASA工具在预测暴力方面的表现.
- 检查DASA在各种住院临床单位的有效性.
- 在DASA框架内探索替代风险分类.
主要方法:
- 一项纵向研究包括3819个连续的心理健康入院病例 (2016-2019).
- 使用了时间到事件分析和接收器操作特征曲线下的区域 (AUC).
- 主要结局是第一个暴力事件或克制事件.
主要成果:
- 17%的患者至少经历过一次暴力事件.
- DASA得分显示了与暴力的显著关联 (AUC = 0.73).
- 在法医,精神分裂症和急症病房 (0.71-0.75) 中,AUC 值一致,但在老年病房 (0.66) 中较低.
结论:
- 该DASA工具在预测不同精神病科的住院患者暴力风险方面表现出可靠的性能.
- 提出的基于DASA的暴力风险类别可以帮助识别低风险患者和那些最容易接受干预的患者.
- 这些发现支持DASA在通过有针对性的减少暴力战略来提高患者和工作人员安全方面的实用性.
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