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Construct validity of the Mechanical Restraint – Confounders, Risk, Alliance Score (MR-CRAS): a new risk assessment instrument.

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Title: Construct validity of the Mechanical Restraint – Confounders, Risk, Alliance Score (MR-CRAS): a new risk assessment instrument.
Authors: Nielsen, Lea Deichmann (AUTHOR), Bech, Per (AUTHOR), Hounsgaard, Lise (AUTHOR), Gildberg, Frederik Alkier (AUTHOR)
Source: Nordic Journal of Psychiatry. Aug2019, Vol. 73 Issue 6, p331-339. 9p.
Subjects: Risk assessment, Test validity, Psychiatric nursing, Nurses' aides, Rank correlation (Statistics)
Abstract: Background: A new short-term risk assessment instrument, the Mechanical Restraint – Confounders, Risk, Alliance Score (MR – CRAS) checklist, including three subscales with altogether 18 items, has been developed in close collaboration with forensic mental health nurses, psychiatrists' etc., and shows evidence of being comprehensible, relevant, comprehensive and easy to use for assessing the patient's readiness to be released from mechanical restraint. Aim: The aim of this study was to investigate whether the subscales: confounders, risk and parameters of alliance constituted separate subscales and needed further revisions. Materials and methods: MR – CRAS was field-study tested among nurses, nurse assistants and social and health care assistants in 13 Danish closed forensic mental health inpatient units, and a Mokken analysis of scalability and a Spearman correlation analysis were performed. Results: MR – CRAS was completed by clinicians in 143 episodes of mechanical restraint, representing 88 patients, with a mean duration of 63.25 hours. Most patients were younger men, diagnosed within the schizophrenia spectrum. One-third of the patients had repeated mechanical restraint episodes ranging between 2 and 8 episodes. MR – CRAS and especially the parameters of alliance were perceived as usable for assessment of the patient's readiness to be released from mechanical restraint. The psychometric analyses showed that the three subscales were unidimensional. Conclusions: The study shows evidence of the construct validity of MR – CRAS among clinicians at closed forensic mental health inpatient units. MR – CRAS contributes with a common language and structured, systematic and transparent observations and assessments on an hour by hour basis during mechanical restraint [ABSTRACT FROM AUTHOR]
Copyright of Nordic Journal of Psychiatry is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Construct validity of the Mechanical Restraint – Confounders, Risk, Alliance Score (MR-CRAS): a new risk assessment instrument.
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  Data: <searchLink fieldCode="AR" term="%22Nielsen%2C+Lea+Deichmann%22">Nielsen, Lea Deichmann</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bech%2C+Per%22">Bech, Per</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hounsgaard%2C+Lise%22">Hounsgaard, Lise</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gildberg%2C+Frederik+Alkier%22">Gildberg, Frederik Alkier</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Nordic+Journal+of+Psychiatry%22">Nordic Journal of Psychiatry</searchLink>. Aug2019, Vol. 73 Issue 6, p331-339. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Test+validity%22">Test validity</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatric+nursing%22">Psychiatric nursing</searchLink><br /><searchLink fieldCode="DE" term="%22Nurses'+aides%22">Nurses' aides</searchLink><br /><searchLink fieldCode="DE" term="%22Rank+correlation+%28Statistics%29%22">Rank correlation (Statistics)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: A new short-term risk assessment instrument, the Mechanical Restraint – Confounders, Risk, Alliance Score (MR – CRAS) checklist, including three subscales with altogether 18 items, has been developed in close collaboration with forensic mental health nurses, psychiatrists' etc., and shows evidence of being comprehensible, relevant, comprehensive and easy to use for assessing the patient's readiness to be released from mechanical restraint. Aim: The aim of this study was to investigate whether the subscales: confounders, risk and parameters of alliance constituted separate subscales and needed further revisions. Materials and methods: MR – CRAS was field-study tested among nurses, nurse assistants and social and health care assistants in 13 Danish closed forensic mental health inpatient units, and a Mokken analysis of scalability and a Spearman correlation analysis were performed. Results: MR – CRAS was completed by clinicians in 143 episodes of mechanical restraint, representing 88 patients, with a mean duration of 63.25 hours. Most patients were younger men, diagnosed within the schizophrenia spectrum. One-third of the patients had repeated mechanical restraint episodes ranging between 2 and 8 episodes. MR – CRAS and especially the parameters of alliance were perceived as usable for assessment of the patient's readiness to be released from mechanical restraint. The psychometric analyses showed that the three subscales were unidimensional. Conclusions: The study shows evidence of the construct validity of MR – CRAS among clinicians at closed forensic mental health inpatient units. MR – CRAS contributes with a common language and structured, systematic and transparent observations and assessments on an hour by hour basis during mechanical restraint [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Nordic Journal of Psychiatry is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Aug2019
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