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Staff perceptions of facilitators and barriers to the use of a short-term risk assessment instrument in forensic psychiatry
Department of Forensic Psychiatry, Linköping University, Vadstena, Sweden.
Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
Department of Medical Specialist, Linköping University, Motala, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.
2018 (English)In: Journal of Forensic Psychology Practice, ISSN 1522-8932, E-ISSN 1522-9092, Vol. 18, no 3, p. 199-228Article in journal (Refereed) Published
Abstract [en]

Prospective adverse events within forensic settings should be assessed using structured risk assessment instruments. Our aim was to identify the barriers and facilitators of a structured instrument for assessment of short-term risk within inpatient forensic psychiatric care. The instrument was piloted at a forensic psychiatric clinic. Three focus group interviews were conducted with staff. Content analysis revealed three main categories of barriers and facilitators for clinical use: implementation object, context, and users. Complexity of the instrument, insufficient continuous training and support, difficulties retrieving assessments on wards, and insecurity about translating assessments into actions were perceived barriers to clinical use. Routines for documentation improved communication and the inclusion of protective and short-term dynamic clinical factors were perceived as clinically relevant. Problem-solving ability, attitude, and motivation of staff were facilitating factors. Comprehensive risk assessment instruments require substantial support for staff to find them manageable. Systematic documentation is required to measure actual daily clinical use.

Place, publisher, year, edition, pages
Taylor & Francis, 2018. Vol. 18, no 3, p. 199-228
Keywords [en]
structured risk assessment, START, implementation, clinical use of research evidence
National Category
Forensic Science
Identifiers
URN: urn:nbn:se:hj:diva-42416DOI: 10.1080/24732850.2018.1466260ISI: 000452643000001Scopus ID: 2-s2.0-85075149034OAI: oai:DiVA.org:hj-42416DiVA, id: diva2:1274713
Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-12-05Bibliographically approved

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CiteExportLink to record
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