Verktøy / Strukturert klinisk risikovurderingPsykometri

V-RISK-10 (Voldsrisiko sjekkliste-10) - Voldsrisikovurdering

Strukturert klinisk risikovurderingPsykometri / Sist oppdatert den 11. February 2015

Dette er en kort screening sjekkliste med 10 ledd som dekker historiske, kliniske og risikohåndteringsvariabler. Uttestingen har vist høy interrater-reabilitet. V-RISK-10 er validert i flere helseforetak og det er funnet høy prediktiv validitet for sjekklisten.

Klinisk anvending: Screening sjekkliste i akutt- og allmennpsykiatri.

En ti-punkts sjekkliste som inneholder et utvag av de viktigste risikofaktorene for fremtidig vold. Utarbeidet fra 2005, og validert frem til 2007 på vel 1.000 inneliggende pasienter i akuttpsykiatriske avdelinger i Oslo og Ålesund, og knapt 400 utskrevne derfra med oppfølgingstid ett år. Sjekklisten er et screeninginstrument, som bør følges opp med nærmere individuell risikovurdering der dette finnes riktig. Beregnet til å brukes uten spesiell forhåndopplæring, slik at både for eksempel turnuskandidater og leger i spesialistutdanning kan bruke det i daglig drift. V-RISK-10 er tatt i bruk i en rekke andre land, som Sverige, Finland, UK, USA, Russland, Kina. Oversatt til engelsk, russisk og kinesisk. Det arbeides også med en Ukrainsk oversettelse. Publikasjonsreferanser og gratis bruk av sjekklisten finnes ved søk på V-RISK-10.

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In english:

The V-RISK-10 is a brief screening checklist with 10 items covering historical, clinical and risk management variables. It has shown a high inter rater reliability, and further a high predictive validity, i.e. with values over 0.80 in Receiver Operating Characteristics (ROC) analysis.

  The screen was constructed in 2005 and was validated for hospitalized patients until 2007 (N= 1.000), and for discharged/ambulatory patients (N= 400) until 2009. It is meant for use without special training for specialists and trainees in psychiatry and clinical psychology, and further for team based assessment with other health professionals.

   V-RISK-10 is presently (2015) widely used in Norway, also in parts of Sweden, Finland, UK, USA, Russia, China and Ukraine.  It is been translated into English, Swedish, Russian, Chinese, and currently Ukrainian.

Main publication references found by search in PubMed (v-risk-10).

Main instructions for use

The most important basis for violence risk assessment has always been a combination of clinical knowledge and sound sense .Earlier research has however shown that the use of checklists can improve the assessments. In the start the checklists were elaborated and used in forensic psychiatric practice. Regarding acute and general psychiatry, these tools were too time consuming for the high and rapidly circulating numbers of patients in this field of the services, something that led to the development of brief checklists. The main impact of these is to help the clinicians in their final clinical assessment. Even experienced clinicians may overlook items that may be of central importance for the real risk of violent acting out. Less experienced colleagues may need the help of tools that always should be at hand in the daily work with many patients. It is however important to remember that risk assessment checklists never can be compared to laboratory tests in somatic medicine. Their main aim is to help the clinical assessment, for the brief checklists (screens) also to be an introduction to the more time consuming tools for a selection of patients.

   The construction of V-RISK-10 was influenced by the HCR-20, and hence is a tool in the Structured Professional Judgement (SPJ) tradition. As such we do not support numerical scoring of the items in daily clinical work, in contrast to what is necessary in validation research on the screen. Regarding manual for scoring of the items, each has its scoring instructions in the two-paged screen. It contains also concluding paragraphs, so an independent scoring manual is not necessary.

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