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Development of a Direct Aggression and Restriction Observation Checklist (AROC) for Routine Observation in Residential and Inpatient Services for Adults with Intellectual Disabilities
Journal of Mental Health Research in Intellectual Disabilities ( IF 1.6 ) Pub Date : 2019-04-23 , DOI: 10.1080/19315864.2019.1595232
Ede Nagy 1 , Meike Wehmeyer 1 , Franziska Gaese 2 , Elisabeth Nicolai 3 , Jochen Schweitzer-Rothers 1, 3
Affiliation  

Introduction: This article describes the development of an Aggression and Restriction Observation Checklist (AROC) for use in residential and in-patient services for adults with intellectual disabilities (ID). The AROC was developed in collaboration between researchers and frontline staff. It assesses self-, person-, and object-directed aggressive behaviours and the staff’s use of restrictive measures, as well as mechanical restraints, physical restraints, or exclusions requested by the residents/patients themselves. AROC has been developed as an outcome tool to measure changes in the level of incidents during a two-year collaboration with professional carers (both residential and ward staff) participating in a family-systems staff training SYMPA-ID. Psychometric properties of the checklist and program´s effects on the incidents were examined. Methods: Inter-coder agreements were analysed using Kendall’s coefficient of concordance. Test-retest reliability was tested by the intraclass correlation coefficient. Trends of incidents on the psychiatric ward were analysed by descriptive statistics, changes in group homes over time by linear multilevel mixed-effects models. Results: AROC demonstrates a high interrater and test-retest reliability and is easy-to-use by frontline staff working shifts. Mixed-effects models showed that aggressive behaviour was associated with both autism spectrum disorder and severity of ID. This corresponds with previous findings and indicates a convergent validity of the checklist. No effect of time was found, so that the efficacy of the intervention on the number of incidents could not be shown. Conclusions: AROC provides a low-threshold method for measuring aggression and restrictions in the daily routine of residential care homes and in-patient services as well as in scientific studies. The study provides support for the reliability and validity of the AROC.



中文翻译:

制定直接侵略和限制观察清单(AROC),以对智障成年人的住宿和住院服务进行常规观察

介绍:本文介绍了开发用于侵害智力障碍成人(ID)的住宿和住院服务的侵略和限制观察清单(AROC)。AROC是在研究人员和一线员工之间合作开发的。它评估自我,个人和对象导向的攻击行为,以及员工使用限制性措施以及居民/患者自身要求的机械约束,身体约束或排斥。AROC已开发为一种成果工具,可与参与家庭系统员工培训SYMPA-ID的专业护理人员(包括住宅和病房工作人员)进行为期两年的合作,以测量事件级别的变化。检查清单的心理计量特性以及程序对事件的影响。方法:使用肯德尔一致性系数分析编码间协议。通过组内相关系数测试重测信度。通过描述性统计分析精神病房中的事件趋势,通过线性多级混合效应模型分析团体房屋随时间的变化。结果:AROC表现出很高的跨度和重测可靠性,并且易于前线工作人员轮班使用。混合效应模型显示,攻击行为与自闭症谱系障碍和ID的严重程度有关。这与以前的发现相对应,表明核对表的收敛有效性。没有发现时间的影响,因此无法显示干预对事件数量的有效性。结论:AROC提供了一种低阈值方法,用于测量日常护理院和住院服务以及科学研究中的侵略和限制。该研究为AROC的可靠性和有效性提供了支持。

更新日期:2019-04-23
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