Abstract

Introduction: Violence in psychiatric settings has negative consequences on patients, staff, and the institution alike. Efforts to prevent violence cannot currently be assessed due to a lack of suitable indicators. The Violence Prevention Climate Scale (VPC-14) is a validated tool that can be filled out by both staff and patients to assess the violence prevention climate in mental health care units. Objective: This study aimed to conduct the translation and adaptation of the VPC-14 to a French Canadian context, and to assess its psychometric properties in general and forensic psychiatric settings. Methods: This study followed a transcultural approach for validating measuring instruments. Psychometric properties were assessed in 308 patients and staff from 4 mental health and forensic hospitals in Quebec (Canada). Content validity was assessed using a bilingual participant approach. Internal validity was examined through exploratory factor analysis and internal consistency for each care setting using Cronbach’s alpha coefficient analysis. Results: The Échelle modifiée du climat de prévention de la violence [Modified Violence Prevention Climate Scale] (VPC-M-FR) consists of 23 items with a 3-factor structure: 1) staff action, 2) patient action, and 3) the therapeutic environment. Cronbach’s alphas ranging from 0.69 to 0.89 were obtained for the internal consistency of the scale. Discussion and conclusion: The VPC-M-FR has satisfactory psychometric properties for measuring the violence prevention climate in mental health and forensic settings. By measuring the violence prevention climate from the standpoint of patients and staff, targeted preventive measures can be implemented to improve safety for all.

Highlights

  • Violence in psychiatric settings has negative consequences on patients, staff, and the institution alike

  • Our results showed that the mean score of the VPC-M-FR and the 40-item preliminary version of the VPC-14 did not differ statistically in a subsample of our study

  • The Violence Prevention Climate Scale is at the crossroads of violence prevention and the climate in the unit

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Summary

Introduction

Violence in psychiatric settings has negative consequences on patients, staff, and the institution alike. The Violence Prevention Climate Scale (VPC-14) is a validated tool that can be filled out by both staff and patients to assess the violence prevention climate in mental health care units. Discussion and conclusion: The VPC-M-FR has satisfactory psychometric properties for measuring the violence prevention climate in mental health and forensic settings. Discussion et conclusion : Le VPC-M-FR possède des propriétés psychométriques satisfaisantes pour mesurer le climat de prévention de la violence en milieu de santé mentale et médico-légal. One American study found that 55% of nurses working in psychiatric settings were exposed to physical violence (Spector et al, 2014) It is challenging for the staff, for nurses in particular who must both prevent and manage violent behavior while being the target of such behavior (Hallett et al, 2014). The direct economic costs of inpatient agitation in psychiatric settings represent 6.87% of the total cost of acute hospitalizations (Serrano-Blanco et al, 2017)

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