title: The Aggression Observation Short Form identified episodes not reported on the Staff Observation Aggression Scale--Revised.
abstract: The purpose of this study is to evaluate the underreporting of violence and aggression on the Staff Observation Aggression Scale-Revised (SOAS-R) when compared to a simpler assessment: the Aggression Observation Short Form (AOS). During a period of one year, two open and two closed wards gathered data on both the SOAS-R and the AOS for all of their patients. The 22-item SOAS-R is to be filled out after each violent episode. The 3-item AOS is to be filled out during each shift and should also record the absence of violence. The SOAS-R registered 703 incidents and the AOS registered 1,281 incidents. The agreement between the SOAS-R and the AOS was good (kappa = 0.65, 95% CI = 0.62-0.67). Among the 1,281 AOS episodes, 51% were also registered on the SOAS-R. For the 176 AOS episodes with harm, 42% were also registered on the SOAS-R. We found 44% missing registrations on the AOS, primarily for open wards and for patients with short admission lengths. Standard instruments such as the SOAS-R underreport aggressive episodes by 45% or more. Underreporting can be reduced by introducing shorter instruments, but it cannot be completely eliminated.
authors.affiliation: Mental Health Center Sct. Hans, Forensic Psychiatry Department, Boserupvej, Roskilde, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Hvidhjelm
authors.forename: Dorte
authors.initials: D
authors.lastname: Sestoft
authors.forename: Jakob Bue
authors.initials: JB
authors.lastname: Bjørner
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data*; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000451:nursing*; D008875:Middle Aged; D009737:Nursing Records / Q000706:statistics & numerical data*; D019370:Observation; D011567:Psychiatric Department, Hospital; D012308:Risk Management; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult