Evaluation of the Violence Prevention Initiative TERMA in Forensic Psychiatric Inpatient Care

NCT05932108 | Unknown

• 1 other identifier: TERMA
• Study Type: observational
• Target: 300
• Locations: 0 countries
• Sites: N/A

Brief Summary

The aim of this project is to evaluate the violence prevention method Therapeutic meeting with aggression (TERMA) regarding adverse events and perceived safety by patients and staff within forensic psychiatric inpatient care. Additionally, the project will investigate whether the organizational culture influences the implementation of the TERMA method and the experiences of patients and staff in situations involving threats, violence, and the use of coercive measures.

Conditions

Forensic Nursing; Forensic Psychiatry

Outcome Measures

Primary Outcomes (2)

• Perceived Safety Questionnaire (E13)

  Questionnaire data on perceived safety. E13 measures factors such as self-estimated safety, feeling of safety, acts of violence and coercion, reaction and aggression measurements and cause of aggression in the wards. The questionnaire consists of 13 statements whose agreement is answered on a four-point Likert scale from completely agree to completely disagree. Minimum value=13, maximum value=52, higher values means better outcome.

  Change measure (baseline to 6 months)

• Perceived Safety Questionnaire (E13)

  Questionnaire data on perceived safety. E13 measures factors such as self-estimated safety, feeling of safety, acts of violence and coercion, reaction and aggression measurements and cause of aggression in the wards. The questionnaire consists of 13 statements whose agreement is answered on a four-point Likert scale from completely agree to completely disagree. Minimum value=13, maximum value=52, higher values means better outcome.

  Change measure (baseline to 1 year)

Secondary Outcomes (11)

• Organisations Value Questionnaire (OVQ).

  Change measure (baseline to 6 months)

• Organisations Value Questionnaire (OVQ).

  Change measure (baseline to 1 year)

• Organisations Value Questionnaire (OVQ)_Safety Questionnaire (E13)

  Baseline

• Organisations Value Questionnaire (OVQ)_Safety Questionnaire (E13)

  6 months

• Organisations Value Questionnaire (OVQ)_Safety Questionnaire (E13)

  1 year

Study Arms (2)

Staff

Educational intervention in TERMA. All staff are required to attend the education.

Behavioral: Education in TERMA

Patients

Patients will not attend any education in TERMA. Data will be collected before and after the staffs education to se if the patients think the attitude of the staff have changed.

Other: Changed work routines based on TERMA

Interventions

Education in TERMA BEHAVIORAL

Education of staff in TERMA. The primary aim of TERMA is to prevent aggression and violence through a system of low-effective treatment that is divided into escalating levels based on the patient's aggression level, risk of violence, and acts of violence . The TERMA model focuses on treatment, communication, and management of compassionate healthcare in forensic psychiatric settings . The levels of the TERMA model are in a "cascading" order, whereby if the treatment and management of one level are ineffective, the next level is initiated, and so on. The primary level involves the daily behavior and health status of the patient. The secondary level involves risk assessment and violence management, with a focus on creating an understanding of the situation for both the patient and healthcare workers. The tertiary level is utilized when violence cannot be avoided . Each level corresponds to a specific response according to the demands of the situation and environment.

Staff

Changed work routines based on TERMA OTHER

NO planned intervention but staff work routines and behavior may change after their education in TERMA. Patients are exposed to these changes.

Patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Staff at a forensic psychiatry department. Patients at a forensic psychiatry departmen

You may qualify if:

• ≥ 18 years of age who
• work in forensic psychiatric inpatient care,
• understand and speak Swedish or English, and are
• willing to participate and sign a consent form.

You may not qualify if:

• not willing to participate
• ≥ 18 years of age who are
• admitted to forensic psychiatric inpatient care according to the Swedish Forensic Psychiatric Care Act,
• understand and speak Swedish or English,
• have approval to participate from the treating physician, and are
• willing to participate and sign a consent form.
• not willing to participate

Sponsors & Collaborators

• Vastra Gotaland Region: lead

MeSH Terms

Interventions

Educational Status

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics

Study Officials

• Sara Wallström, PhD

  Västra Götalandsregionen

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sara Wallström, PhD

CONTACT

0701-714468; sara.wallstrom@vgregion.se

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 15, 2023
• First Posted: July 6, 2023
• Study Start: July 15, 2023
• Primary Completion: February 25, 2024
• Study Completion: September 25, 2024
• Last Updated: July 11, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share