Critical evaluation of the hcr-20 violence risk assessment: the perception of persons with abi of their involvement in risk decision making
Abstract
ABSTRACT
This idiographic, qualitative research sought to investigate the perceptions of patients with ABI regarding the utility of a collaborative process when completing the HCR-20 risk assessment. Four male participants detained under the Mental Health Act (1983, amended 2007), in medium- and low-secure facilities completed semi-structured interviews to allow for rich, detailed accounts to be obtained. Anonymity and confidentiality of participant information was maintained throughout, including specific details of the hospital and violent behaviours they have portrayed. An inductive thematic analysis identified three themes at the semantic level forming the basis of the discussion. The themes identified were; ‘comprehension of the HCR-20 assessment and effective communication’, ‘benefits of assessment engagement and motivation to change’, and ‘externalisation of behaviour, responsibility and control’. The findings led to recommendations for professional consideration that are believed to improve clinical-practice, specifically regarding the way HCR-20 risk assessments are conducted within medium- and low-secure hospital settings.
Keywords:Â HCR-20; risk-assessment; patient; perspective; collaboration.
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RESUMEN
Esta investigación cualitativa ideográfica ha buscado estudiar las percepciones de los pacientes con lesión cerebral adquirida acerca de la utilidad del proceso colaborativo cuando son sometidos al HCR-20 para la evaluación del riesgo de la violencia. Cuatro participantes detenidos por la Ley de Salud Mental inglesa (de 1983, cambiada en 2007), en instalaciones de media y baja seguridad, completaron entrevistas semiestructuradas resultando en relatos ricos y detallados. El anonimato y la confidencialidad de las informaciones de los participantes fueron mantenidos al largo de todo el proceso, incluyendo detalles especÃficos del comportamiento hospitalario y del comportamiento violento de ellos. Un análisis temático inductivo ha identificado tres temas de nivel semántico formando la base de esta discusión. Los temas identificados fueron: ‘la comprensión de la evaluación HCR-20 y la comunicación efectiva’, ‘los beneficios de la participación evaluativa y la motivación para el cambio’, y ‘la externalización del comportamiento, la responsabilidad y el control’. Los resultados lograron recomendaciones para una consideración profesional que se cree permitir perfeccionar la práctica clÃnica, especialmente en lo que se refiere a la forma con que las evaluaciones de riesgo por el HCR-20 son conducidas dentro de las configuraciones hospitalarias de baja y media seguridad.
Palabras Clave: HCR-20; evaluación del riesgo; paciente; perspectiva; colaboración.
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RESUMO
Esta pesquisa qualitativa ideográfica buscou investigar as percepções de pacientes com lesão cerebral adquirida envolvendo a utilidade do processo colaborativo quando completam o HCR-20 para avaliação do risco de violência. Quatro homens participantes detidos sob a Lei de Saúde Mental inglesa (de 1983, alterada em 2007), em unidades de média e baixa segurança, preencheram entrevistas semiestruturadas permitindo que relatos ricos e detalhados fossem obtidos. O anonimato e a confidencialidade das informações dos participantes foram mantidos ao longo de todo o processo, incluindo detalhes especÃficos do comportamento hospitalar e do comportamento violento perpetrados por eles. Uma análise indutiva temática identificou três temas de nÃvel semântico formando a base desta discussão. Os temas identificados foram: ‘a compreensão da avaliação HCR-20 e a comunicação efetiva’, ‘benefÃcios do engajamento avaliativo e motivação para mudança’, e ‘externalização do comportamento, responsabilidade e controle’. Os achados levaram a recomendações para uma consideração profissional que acredita-se poder impulsionar a prática clÃnica, especialmente no que se refere à forma com que as avaliação de risco pelo HCR-20 são conduzidas dentro das configurações hospitalares de baixa e média segurança.
Palavras-chave: HCR-20; avaliação do risco; paciente; perspectiva; colaboração.Â
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