ABSTRACT As violence toward healthcare personnel escalates worldwide, nurses seek methods to identify patients at risk for aggression before harm occurs. Multiple assessment guides for aggression risk are available for psychiatric patients. However, few assessment tools have been tested with patients hospitalized in non‐psychiatric settings. This observational study examined the reliability and validity of the Dynamic Appraisal for Situational Aggression (DASA) tool in hospitalized adults. Data extracted from electronic health records of inpatients in one hospital in 2024 included baseline DASA assessments and aggressive acts within 12–24 h post‐baseline. The convenience sample ( n = 1,347) was predominantly older Caucasian adults. Nurses ( n = 80) tested inter‐rater reliability in 40 inpatients. An intraclass correlation coefficient of 0.93 for the overall score and Kappa scores of 0.56–1.00 for the items indicated nurses used the DASA consistently. Patients categorized as high risk demonstrated nearly 18 times more aggressive acts compared to low‐risk patients (16.0% vs. 0.9%). Furthermore, patients categorized as moderate or high risk demonstrated a greater likelihood of aggression 12–24 h post‐baseline compared with low‐risk patients (2.9% and 16.0% vs. 0.9%, respectively). DASA risk category was significantly associated with aggressive acts 12–24 h post‐baseline (Fisher‐Freeman‐Halton Exact Test = 19.11, p < 0.001). Results offer early support for the reliability and validity of the DASA in a new clinical population. Further testing in diverse settings with greater numbers of aggressive events may provide additional evidence for the usefulness of the DASA in the early identification of inpatients at risk for aggression.
ABSTRACT Perinatal posttraumatic stress disorder (PPTSD) is a public health concern with serious implications for maternal and infant health outcomes. However, clinical research for PPTSD treatment is minimal. Thus, we aim to help address this gap by evaluating the feasibility, acceptability, and preliminary effectiveness of a tailored PPTSD intervention through a pilot randomized controlled trial (RCT; hereafter referred to as the New Empowerment after Trauma (NEXT) study). The NEXT study also aims to engage those most likely to experience PPTSD and least likely to engage in care, including Black and rural‐dwelling perinatal individuals. Enrolled perinatal individuals with PPTSD will be randomized to receive either: 1) perinatal‐tailored Narrative Exposure Therapy (NET) ( n = 45 completers; treatment group) or 2) enhanced usual care ( n = 45 completers; comparator group). This pilot RCT protocol is a critical step towards advancing transparency and reproducibility in perinatal PTSD research, particularly for a population that has been underrepresented in clinical research and warrants further attention. Patient and Public Contributions : Perinatal individuals with PPTSD have shaped the development of this protocol through our preliminary work. Specifically, perinatal individuals with lived experiences of PPTSD contributed to NEXT study materials and the adaptation of the intervention protocol.
