Application Of Chinese Version Of Br?set Violence Checklist In Children And Adolescents With Mental Illness

BackgroundThe risk judgement of psychiatric violence has always been a difficult task in the psychiatric clinical work.With the development of the risk judgement model for violence,structured clinical judgement is satisfactory method for dynamically monitoring and judging the risk of patient violence through nurses.In many risk judgment scales,the assessors choose the best tools to assessing the risk of violence in patients,and adopts active and effective preventive measures for high-risk subjects to reduce the occurrence of violent incidents.This has very important clinical significance.At present,the Br?set Violence Checklist has been used as a simple and effective structured clinical judgment tool by Chinese scholars and has been form the Chinese version of the Br?set Violence Checklist.However,this scale has not specifically targeted for the Chinese children with adolescent mental illness.Therefore,the reliability and validity of the Chinese version of the Br?set Violence Checklist in children and adolescents with mental illness needs to be further verified and perfect.Objectives1.To test the reliability and validity of the Chinese version of the Br?setViolence-Checklist(BVC)in Chinese children and adolescents with mental illness.2.To explore the influencing factors of predictive validity of Chinese version of the Br?set Violence Checklist(BVC).Methods1.Six psychiatric and mental health specialists working in clinical psychiatry to assess the content validity of the Chinese version of the Br?set-Violence-Checklist.2.The subject's researchers conducted a unified training course for the psychiatric clinical nurses participating in the study,so that the 8 qualified nurses independently evaluated 15 cases of the same patient.The intra-group correlation coefficient(ICC)was used to evaluate the amount.The inter-rater reliability of the table.3.Adopting a convenient sampling method,selected Henan Province Psychiatric Hospital Who Ages of 4-16 years are schizophrenia,bipolar disorder,mania,childhood emotional disorder hospitalized children 271 patients with adolescent mental illness is to meet the Diagnostic and Statistical Manual of Mental Disorders DSM-4 diagnostic criteria.4.The Chinese version of the BVC was used to evaluate patients once every 8 hours(early morning,middle and evening),and the evaluation period was 7 days.Using the Child Behavior Checklist(CBCL)aggressiveness dimension to test the simultaneous validity of the Chinese version of the BVC.Test the predictive validity of the Chinese version of the BVC based on the actual results of violent behavior.Using Cronbach's ? coefficient and the total relevance tested the internal consistency of the Chinese version of the BVC.5.To analyze the relevant factors affecting the predictive validity of the Chinese version of the BVC.6.Data Entry: Use Microsoft Excel software to create a database.7.Statistical Analysis: This study used SPSS19.0 statistical software for data processing and analysis.Results1.Incident of violence: During the study,the nurses conducted 320 Chinese children with adolescent mental illness using the Chinese version of the BVC to assess the risk of violence,of which 178 were male(55.6%)and 23 were aged 4-11(13.92%),155 cases(87.07%)12-16 years old,142 cases(44.4%)women,20 cases(14.08%)age 4-11 years old,122 cases(85.92%)12-16 years old,average age(13.88 ± 2.09)years old.There were 166 cases of violence and 154 cases of no violence.2.Validity test of the Chinese version of the BVC(1)Content validity: The content validity(S-CVI)of the scale is 0.91,and the content validity(I-CVI)of each item level of the scale is Confusion(0.67),Irritability(1.00),Ambiguity(0.83),Verbal Threat(1.00),Physical Threat(1.00),Destructive Behavior(1.00),Expresed Content Validity better in Other 5 Item Levels except Item 1(confusion).(2)Predictive validity: The Kruskal-Wallis test results suggest that there is a difference between the actual occurrence of the violence and the risk assessment results in the low-risk,moderate-risk,and high-risk groups.Non-parametric test results suggested that the low-risk groups,middle-risk groups,and high-risk groups had statistically significant differences in the mean scores of the Chinese version of the BVC.The t-test results of two independent samples from two groups of patients with real violence and non-violence showed statistical significance in the scale scores(t=-15.889,P<0.01).It indicates that the scale has good predictive validity.The area under the ROC curve showed that AUC(Area Under the Curve)was 0.928(95%-CI:0.894-0.954).When the best critical point was 6,the corresponding Youden index was 0.7270.The sensitivity and specificity of the tool reached the maximum.At this time,the sensitivity(Se)was 83.7% and the Specificity(Sp)was 89.0%.(3)Validity of school-marking: In this study,the CBCL was selected as the school-marking assessment of the Chinese version of the BVC.The results showed that the Achenbach CBCL Scale was aggressive.There was a moderate positive correlation between the Chinese BVC scale scores(r=0.317,P<0.01).3.Reliability test of the Chinese version of the BVC(1)Inter-rater consistency reliability results of scales show intragroup correlation coefficient ICC index is 0.867(P<0.001),confusion(0.861),and ease Irritability(0.853),noisiness(0.874),verbal threat(0.930),physical threat(0.832),and destructive behavior(0.874)suggested that trained evaluators were able to use the tool correctly.(2)Internal consistency reliability of the BVC: The statistical results show that the Cronbach's ? coefficient of the BVC is 0.897,indicating that the items in the scale have high internal consistency.The Pearson correlation analysis showed that the six items in the Chinese version of the BVC : confusion,irritability,loud noise,verbal threats,physical threats,and total object damage and total score were r= 0.601?0.692?0.747?0.807? 0.806? 0.806,P<0.01,suggesting that the six items have good correlation.4.To assess the predictive validity of the Chinese version of BVC for multiple factors such as family history of categorical variables,pre-hospital attack behavior,maternal occupation,and type of diagnosis in patients' sociodemographic data that may influence the predictive validity of the Chinese version of the BVC.The analysis of the difference between the area under the ROC curve,the results show that the history of attack behavior before admission is the most important influencing factor of the Chinese version of BVC scale in children with adolescent mental illness.Conclusions1.The Chinese version of BVC has good reliability,predictive validity,and simultaneous validity in the application of children with adolescents mental illness in China,,but item 1(Confusion)Content validity is poor,and the content of the remaining five items is better.2.pre-hospital attack behavior,family history,maternal occupation,and type of diagnosis were factors influencing the predictive validity of the Chinese version of the BVC in children and adolescents with mental illness.