Using the Dynamic Appraisal of Situational Aggression with mental health inpatients: a feasibility study

Figures & data

Table 1 Threefold data collection

Data collection	Participants (in total/3 units)
Demand: actual use of DASA instrument
Prior to the study
Back-translation of instrument	N/A
Training of the nursing staff	N/A
During the study
Daily completion of DASA assessments	N/A
After the study
Information about patients’ treatment days during the study, and realized amount of assessments	DASA assessments (treatment days), potential amount (n=1,116)
	DASA assessments, realized amount (n=716)
Acceptability: patient recruitment ratio; limited efficacy: predictive validity
During the study
Daily DASA assessments	Risk assessments in total (n=178)
	Patients with informed consent (n=12)
Acceptability: patients’ perceptions of strengths and weaknesses of DASA use
Meeting prior to the study
Introduction of the DASA	Patients (n=27)
Procedure of instrument use during the study
Preliminary perceptions of the DASA
Meeting during the study
Strengths and weaknesses of DASA use	Patients (n=26)
Meeting after the study
Strengths and weaknesses of DASA use	Patients (n=19)
	Written feedback (n=5)

Abbreviations: DASA, Dynamic Appraisal of Situational Aggression; N/A, not applicable.

Table 2 Use of DASA in study units

Unit	DASA assessments (treatment days), potential amount	Amount of realized DASA assessments (% out of potential amount)	DASA assessments (% out of realized amount)
Unit A	315	208 (66.0%)	11 (5.3%)
Unit B	270	38 (14.7%)	38 (100%)
Unit C	531	470 (88.5%)	129 (27.4%)
Total	1,116	716 (64.2%)	178 (24.9%)

Abbreviation: DASA, Dynamic Appraisal of Situational Aggression.

Figure 1 Dynamic Appraisal of Situational Aggression assessment scores during 1-month study.

Table 3 Predictive validity of the DASA

Type of aggression occurring during the next 24 hours	DASA total score, AUC (95% CI)	Nurses’ judgment on final risk rating, AUC (95% CI)*
Physical aggression against objects (n=0)	N/A	N/A
Physical aggression against others (n=3)	0.92 (0.87–0.97)	0.78 (0.46–1.00)
Verbal aggression against others (n=5)	0.86 (0.62–1.00)	0.75 (0.49–1.00)

Note:

* Risk of aggression was rated as low, moderate, or high.

Abbreviations: DASA, Dynamic Appraisal of Situational Aggression; AUC, area under the curve; CI, confidence interval; N/A, not applicable.