The Staff Observation Aggression Scale – Revised (SOAS-R) – adjustment and validation for emergency primary health care

Abstract

BackgroundMany emergency primary health care workers experience aggressive behaviour from patients or visitors. Simple incident-reporting procedures exist for inpatient, psychiatric care, but a similar and simple incident-report for other health care settings is lacking. The aim was to adjust a pre-existing form for reporting aggressive incidents in a psychiatric inpatient setting to the emergency primary health care settings. We also wanted to assess the validity of the severity scores in emergency primary health care.MethodsThe Staff Observation Scale - Revised (SOAS-R) was adjusted to create a pilot version of the Staff Observation Scale – Revised Emergency (SOAS-RE). A Visual Analogue Scale (VAS) was added to the form to judge the severity of the incident. Data for validation of the pilot version of SOAS-RE were collected from ten casualty clinics in Norway during 12 months. Variance analysis was used to test gender and age differences. Linear regression analysis was performed to evaluate the relative impact that each of the five SOAS-RE columns had on the VAS score. The association between SOAS-RE severity score and VAS severity score was calculated by the Pearson correlation coefficient.ResultsThe SOAS-R was adjusted to emergency primary health care, refined and called The Staff Observation Aggression Scale - Revised Emergency (SOAS-RE). A total of 350 SOAS-RE forms were collected from the casualty clinics, but due to missing data, 291 forms were included in the analysis. SOAS-RE scores ranged from 1 to 22. The mean total severity score of SOAS-RE was 10.0 (standard deviation (SD) =4.1) and the mean VAS score was 45.4 (SD = 26.7). We found a significant correlation of 0.45 between the SOAS-RE total severity scores and the VAS severity ratings. The linear regression analysis showed that individually each of the categories, which described the incident, had a low impact on the VAS score.ConclusionsThe SOAS-RE seems to be a useful instrument for research, incident-recording and management of incidents in emergency primary care. The moderate correlation between SOAS-RE severity score and the VAS severity score shows that application of both the severity ratings is valuable to follow-up of workers affected by workplace violence.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3157-z) contains supplementary material, which is available to authorized users.

Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

“…The prevalence of aggression per patient was examined, using the Staff Observation Aggression Scale (SOAS) [38], in another Italian study of 1534 patients admitted to a psychiatric unit [39]. Of these, 116 resulted responsible for 329 aggressive episodes (prevalence of aggression = 7.5%; 2.8% incidents/patient).…”

Characteristics of aggressive incidents in emergency primary health care described by the Staff Observation Aggression Scale – Revised Emergency (SOAS-RE)

“…The emergency primary health care version of the Staff Observation Scale was developed for this study by adapting the Staff Observation Scale -Revised [10] into the Staff Observation Aggression Scale -Revised Emergency (SOAS-RE). The adjustment and validation of the scale have been thoroughly reported elsewhere [9].…”

“…An SOAS-RE severity score of 9 or more is judged to be a severe incident, which is the score used to identify severe incidents when using the SOAS-R. Such incidents include all physical attacks causing fear or harm to the victims, as well as attacks against persons using dangerous objects [9]. In addition to marking the relevant factors in the six columns, the worker marks the severity of the aggression on a 100 mm Visual Analogue Scale (VAS) ranging from "not severe at all" (at the 0 end of the VAS) to "extremely severe" (at the 100 end of the VAS).…”

“…Evidence-based assessment procedures have been developed for measuring aggressive incidents in health care settings [5][6][7], and the Staff Observation Aggression Scale -Revised (SOAS-R) is a widely used and valid instrument developed for monitoring aggressive incidents in psychiatric wards [8]. Due to differences between emergency primary health care and psychiatric hospital settings, the SOAS-R needed adjustments and validation in order to be applied in emergency primary health care [9]. The new and validated instrument was called the Staff Observation Aggression Scale -Revised Emergency (SOAS-RE).…”

Der KEZ – Kölner Fragebogen zu Einstellungen zu Zwangsmaßnahmen

“…Der Fragebogen MAVAS (Management of Aggression and Violence Attitude Scale) 21 , der ebenfalls in deutscher Übersetzung vorliegt (MAVAS-SWISS-German) 21 22 , ermittelt die Haltung des psychiatrischen Personals zu Aggression und Gewalt, wobei aber eher die von Patient*innen ausgehende Gewalt und Aggression im Vordergrund steht. Weitere Instrumente wie die SOAS-R (Staff Observation Aggression Scale – Revised) 23 , die PCC-SR (Patient-Staff Conflict Checklist 16 24 , der TCI (Team Climate Inventory) 25 und die WAS (Ward Atmosphere Scale) 26 erfassen verwandte Aspekte, aber nicht direkt die Haltung zu der Anwendung von Zwangsmaßnahmen.…”