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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Physical aggression during admission to a child and adolescent inpatient unit: predictors and impact on clinical outcomes.
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Physical aggression during admission to a child and adolescent inpatient unit: predictors and impact on clinical outcomes.

机译：入院儿童和青少年住院期间的身体攻击：预测因素及其对临床结果的影响。

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OBJECTIVE: Aggressive behaviour is common in young people admitted to child and adolescent inpatient services. Little is known about how physical aggression during admission influences patient outcomes. The aim of the present study was to identify predictors of aggression in a child and adolescent inpatient unit and examine differences in clinical outcomes between aggressive and non-aggressive patients. METHOD: Episodes of aggression occurring within a child and adolescent inpatient unit were prospectively documented between October 2004 and December 2005. Patient factors (demographics, diagnoses, clinical history) were examined as predictors of aggression. Outcomes for admissions in which more than one episode of physical aggression occurred were compared to those in which no aggression occurred. Outcomes assessed were changes in symptom severity (as rated by the Health of the Nation Outcome Scales for Children and Adolescents) length of stay, and initiation of medications. RESULTS: A total of 134 patients were admitted during the study period (61.9% female, mean age=13.8 years, SD=2.9); 31 patients (23.1%) exhibited physical aggression during admission and 20 of these exhibited more than one episode of physical aggression. Factors that predicted persistent physical aggression included history of aggression, use of medications at presentation and absence of self-harm. Persistent aggression was also associated with increased length of stay, but did not compromise improvements in clinical symptom ratings between admission and discharge or lead to increased medication prescribing. CONCLUSION: Contrary to hypotheses and existing research, aggression during admission does not appear to be a barrier to clinical improvement. Further research is necessary to clarify how aggressive children can receive the most benefit from inpatient admission while minimizing the risks to the patient and those around them.
机译：目的：侵害行为在接受儿童和青少年住院服务的年轻人中很常见。关于入院期间的身体攻击如何影响患者预后知之甚少。本研究的目的是确定儿童和青少年住院患者中侵略性的预测因素，并检查侵略性和非侵略性患者之间临床结局的差异。方法：前瞻性地记录了2004年10月至2005年12月在儿童和青少年住院患者中发生的侵略事件。检查了患者因素（人口统计学，诊断，临床病史）作为侵略的预测因素。将发生多于一次身体攻击的入院结果与未发生侵略的结果进行比较。评估的结果是症状严重程度的变化（按国家儿童和青少年健康状况量表评估）的住院时间和药物治疗的时间。结果：研究期间共收治134例患者（女性61.9％，平均年龄= 13.8岁，SD = 2.9）; 31名患者（占23.1％）在入院期间出现身体攻击，其中20例发生了一次以上的身体攻击。预测持续性身体侵略的因素包括侵略史，就诊时使用药物以及无自我伤害。持续的侵略性还与住院时间的延长有关，但并未影响入院与出院之间临床症状分级的改善或导致药物处方的增加。结论：与假设和现有研究相反，入院期间的侵略似乎并不妨碍临床改善。有必要进行进一步的研究以阐明积极进取的儿童如何从住院治疗中获得最大收益，同时最大程度地降低对患者及其周围人群的风险。

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