背景:急性行为障碍(ABD)是执法和医疗保健中使用的术语,但是它的含义缺乏明确性。各工作人员群体应使用共同的语言来支持身份识别,对这组患者的优先次序和护理交付。当前使用的术语不一致且令人困惑。本研究旨在就ABD的识别和管理标准达成共识。并同意何时使用其他护理途径或指南可能更合适。
方法:一项由利益相关者组织代表参与的改良Delphi研究于2023年1月至4月在线进行。在第一轮中,与会者针对广泛的问题发表了声明。然后,参与者在随后的几轮中对他们与声明的协议水平进行了评级,将达成共识的声明删除,以纳入最终得出的共识声明中。评估了非共识声明响应的稳定性。
结果:在提供评级的430个独特陈述中,266位代表八个利益相关者组织的30位参与者达成了共识。从这些声明中得出了共识声明。对未能达成共识的陈述的中位数组反应是可靠的(Krippendorff的α=0·67)。
结论:利益相关方组织达成共识,认为ABD不是鼓动的独立实体,相反,应该改变指导,以解决所有关于激动的介绍。虽然可以描述这种严重激动的患者的关注特征,认可的建议可能因员工群体而异。提供了识别标准,并描述了潜在的新术语。
BACKGROUND: Acute behavioural disturbance (ABD) is a term used in law enforcement and healthcare, but there is a lack of clarity regarding its meaning. Common language should be used across staff groups to support the identification, prioritisation and delivery of care to this group of patients. The terminology currently used is inconsistent and confusing. This study aimed to reach a
consensus on the criteria for identification and management of ABD, and to agree when other care pathways or
guidelines might be more appropriately used.
METHODS: A modified Delphi study with participation from stakeholder organisation representatives was conducted in January-April 2023 online. In round 1, statements were generated by participants in response to broad questions. Participants then rated their level of agreement with statements in subsequent rounds, with statements achieving a consensus removed for inclusion in the final derived
consensus statement. Non-
consensus statement responses were assessed for stability.
RESULTS: Of 430 unique statements presented for rating, 266 achieved a consensus among 30 participants representing eight stakeholder organisations. A derived
consensus statement was generated from these statements. The median group response to statements which failed to achieve a consensus was reliable (Krippendorff\'s alpha=0·67).
CONCLUSIONS: There is a consensus across stakeholder organisations that ABD is not a separate entity to agitation, and guidance should instead be altered to address the full range of presentations of agitation. While the features of concern in this severely agitated group of patients can be described, the advice for recognition may vary depending on staff group. Criteria for recognition are provided and potential new terminology is described.