ABSTRACT

The Historical Clinical Future-Revised [HKT-R] is a risk assessment tool to support forensic psychiatric professionals in their clinical decisions to prevent future recidivism. A self-report version and App has been developed in co-creation with patients and professionals, the so-called HKT-R Spider App. This App aims to helps patients understand their offense-related risk- and protective factors and become more involved in their treatment. By comparing patient’s self-reports on 14 clinical and seven future-related factors with staff observations, this App aims to facilitate shared decision making. In this study, we examined whether perceptions of risk and protective factors between patients (n = 32) and staff (n = 8) corresponded or differed. Exact agreement was low. Professionals assessed patients significantly higher at risk for eight clinical and four future HKT-R factors. Patients assessed themselves significantly more at risk for psychosis. Score correlations ranged from negative to high-strong. The use of the visual HKT-Spider App is promising as a conversation starter and tool for patients and professionals for shared personalized decision making. It visualizes a treatment trajectory. Patients report that the App is user friendly, informative and useful in the dialogue with their professionals. Further implementation in the forensic field is needed.

摘要

Historical Clinical Future-Revised [HKT-R] 是一种风险评估工具，用于支持法医精神病学专业人员的临床决策，以防止未来再犯。与患者和专业人士共同开发了一个自我报告版本和应用程序，即所谓的 HKT-R Spider App。该应用程序旨在帮助患者了解他们与犯罪相关的风险和保护因素，并更多地参与他们的治疗。通过将患者关于 14 项临床因素和 7 项与未来相关的因素的自我报告与工作人员的观察结果进行比较，该应用程序旨在促进共同决策。在这项研究中，我们检查了患者 ( n =  32) 和工作人员 ( n = 8)对风险和保护因素的看法) 对应或不同。完全一致的程度很低。专业人士评估了八个临床和四个未来 HKT-R 因素的风险明显更高的患者。患者评估自己患精神病的风险明显更高。得分相关性范围从负到高-强。使用可视化 HKT-Spider 应用程序有望成为患者和专业人士的对话启动器和工具，以共享个性化决策。它使治疗轨迹可视化。患者报告说，该应用程序用户友好，信息丰富，在与专业人士的对话中很有用。需要在法医领域进一步实施。