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- Levin, Sara, 1974-, et al.
(författare)
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Adherence to planned risk management interventions in Swedish forensic care : What is said and done according to patient records
- 2019
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 64, s. 71-82
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Tidskriftsartikel (refereegranskat)abstract
- Both structured and unstructured clinical risk assessments within forensic care aim to prevent violence by informing risk management, but research about their preventive role is inconclusive. The aim of this study was to investigate risk management interventions that were planned and realized during forensic care by analysing patient records. Records from a forensic clinic in Sweden, covering 14 patients and 526 months, were reviewed. Eight main types of risk management interventions were evaluated by content analysis: monitoring, supervision, assessment, treatment, victim protection, acute coercion, security level and police interventions. Most planned risk management interventions were realized, both in structured and clinical risk assessments. However, most realized interventions were not planned, making them more open to subjective decisions. Analysing risk management interventions actually planned and realized in clinical settings can reveal the preventive role of structured risk assessments and how different interventions mediate violence risk.
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- Levin, Sara, 1974-, et al.
(författare)
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Risk-Increasing and Risk-Reducing Factors for Violence : A Qualitative Study of Forensic Patients’ Perceptions
- 2022
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Ingår i: International Journal of Forensic Mental Health. - : Taylor & Francis. - 1499-9013 .- 1932-9903. ; 21:4, s. 383-398
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated forensic patients’ perceptions of relevant factors for violence risk, to facilitate an understanding of potential reasons for violence and the effect of risk management interventions. Semi-structured interviews with 13 forensic patients were analyzed with qualitative content analysis using an inductive approach. The sample of participants could identify an array of potentially relevant factors for their use of violence related to themselves, the external context, social and relational aspects, as well as situational factors. Most also actively strived to manage such risk. Considering patients’ perceptions could potentially add relevant perspectives and improve clinical and structured risk assessments.
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- Levin, Sara, et al.
(författare)
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Staff perceptions of facilitators and barriers to the use of a short-term risk assessment instrument in forensic psychiatry
- 2018
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Ingår i: Journal of Forensic Psychology Practice. - : Taylor & Francis. - 1522-8932 .- 1522-9092 .- 2473-2850 .- 2473-2842. ; 18:3, s. 199-228
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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- Levin, Sara, et al.
(författare)
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Structured risk assessment instruments : A systematic review of implementation determinants
- 2016
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Ingår i: Psychiatry, Psychology and Law. - : Informa UK Limited. - 1321-8719 .- 1934-1687. ; 23:4, s. 602-628
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Tidskriftsartikel (refereegranskat)abstract
- Research-based structured risk assessment instruments (SRAIs) can improve violence risk assessment and clinical judgements in mental health and correctional services. Practical challenges of implementing SRAIs have led to calls for more research to understand the determinants influencing this process. Studies describing determinants for SRAI implementation in psychiatric, correctional, or community in-patient settings were systematically reviewed. Findings were analysed according to the Consolidated Framework for Implementation Research. A total of 11 studies were included. Four types of main implementation determinants were found: characteristics of the SRAI; users of the SRAI; inner setting; and process. Findings underscore the importance of applying a multifactorial approach to the implementation of SRAIs to address many different barriers and facilitators. More stringent research is needed to obtain more solid evidence of factors that impede or enable SRAI implementation, especially regarding patient perspectives and outer setting determinants. Constructing shared concepts of determinants across research fields could further aid information transferences.
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