Validity And Reliability Of The Chinese Version Of The Br?set Violence Checklist

Objective:To introduce the BVC scale and test the validity and reliability of the Chinese version of the Br?set-Violence-Checklist(BVC-C) in psychiatric populations in China, to provide a brief, accurate and normative violence prediction instrument for the psychiatric clinical staff in our country.Methords:1. With the authorizing permission by the author, according to the proceeding of translation—back translation—culture adaptation—preliminary test, the BVC was translated into Chinese version.2. Five psychiatry experts who have been worked more than 20 years were invited(three clinical doctors and two nurses) to evaluate the content validity of the scale, and the content validity index was used to indicate the result.3. The nurses who participated in this study were unified training by the researchers. 9 nurses who have passed the examination assessed 14 same cases independently, using the intraclass correlation coefficient(ICC) to evaluate the inter-rater reliability of the scale.4. Using the convenient sampling method, 556 inpatients from The Sixth People’s Hospital of Hebei Province who met the diagnosis criteria for mental disorders according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision(ICD-10) were totally selected to proceed the formal testing. The BVC-C was used to evaluate inpatients every 8 hours, and the Modified Overt Aggression Scale(MOAS) was used to test concurrent validity; the results of the actual attacking incidents were used to test the predictive validity; the internal consistency reliability of the scale was tested by Cronbach α coefficient and item total correlations.5. Data collection: To establish the database by using the EpiData software.6. Statistical analysis: Using the SPSS 19.0 software for data statistics processing.Results:1. Scale recycling: Actually, 571 patients were evaluated, the basic information of 2 cases were not complete, 13 cases were fall out, so the effective cases were 556, 5004 effective evaluation sheets were collected in the nine shifts.2. The time required for evaluation: The overall evaluation time were 1~5(2.16 + 0.88) minutes, 1228(24.5%) evaluation sheets were completed within 1 minute, 2030(40.6%) evaluation sheets were completed within 2 minutes, 1491(29.8%) evaluation sheets were completed within 3 minutes, 203(4.1%) evaluation sheets were completed within 4 minutes, 52(1.0%) evaluation sheets were completed within 5 minutes.3. Validity:(1) Content validity: The content validity index of the scale was 0.93, it suggested that the scale had good content validity.(2) Concurrent validity: In addition to the own attack subscale, the MOAS total scores and the other three subscales scores were positively correlated with the BVC-C total scores and each item score(r=0.11-0.69, P<0.01), which were low to moderate correlation.(3) Predictive validity: The best predictive validity was eight hours through analyzed, when the cut-off was 2, the AUC was 0.98, the sensitivity and specificity were 78.9% and 95.1% respectively.4. Reliability:(1) Inter-rater reliability: The interclass correlation coefficient(ICC) for the six BVC-C items were: confusion, ICC=0.90; irritability, ICC=0.82; boisterousness, ICC=0.82; verbal threats, ICC=0.83; physical threats, ICC=0.84; attacks on objects, ICC=0.93; the ICC value for the total BVC-C socre was 0.93, all of the ICC values was above 0.8 indicated that different evaluators could grasp the assessment tool correctly after training.(2) Internal consistency reliability: The Cronbach α coefficient was 0.76, which showed that high homogeneity between each item of the scale.(3) Item total correlations: Item total correlations refers to the correlation between the research project and the total score, the item total correlations were r=0.47-0.80(P<0.01), which showing that each item measured the properties or content of the scale together.Conclusion:It suggests that the BVC-C has good validity and reliability, and it also received highly approval of nursing staff at the same time. The BVC-C could be used as an effective prediction tool for psychiatric violence risk, and it can be revised and perfected appropriately according the national conditions.