Palmstierna and Wistedt developed the Staff Observation Aggression Scale (SOAS) to describe aggressive behavior by a patient. This can help monitor the patient over time and to evaluate the effectiveness of different interventions. The authors are from Karolinska Institute and Danderyd Hospital in Sweden.
Parameters:
(1) means of aggression
(2) aim (target)
(3) results of aggressive behavior (to an object or to a person)
|
Parameter |
Finding |
Points |
|
means of aggression |
nothing was used |
0 |
|
|
verbal aggression |
1 |
|
|
patient makes use of body part (except for using teeth or trying to strangle) |
2 |
|
|
bites, tries to strangle or uses an ordinary and easily available object |
3 |
|
|
makes use of a dangerous weapon (knife, scissor, tool, etc.) |
4 |
|
aim |
none |
0 |
|
|
object |
1 |
|
|
staff member |
2 |
|
|
other patient |
3 |
|
|
someone else |
4 |
|
results (object) |
no damage |
0 |
|
|
visible damage but still usable |
1 |
|
|
minor damage but needs to be replaced <see note> |
2 |
|
|
major damage and needs to be replaced <see note> |
3 |
|
|
totally destroyed <see note> |
4 |
|
results (person) |
no injury |
0 |
|
|
felt threatened or brief pain (lasting < 10 minutes); no visible injury |
1 |
|
|
pain > 10 minutes or visible injury not requiring treatment |
2 |
|
|
injury requiring some kind of treatment but not necessarily by a physician |
3 |
|
|
injury requires management by a physician |
4 |
where:
• The original table for results affecting at an object stopped at level 2 (object damaged and has to be replaced). In the implementation I expanded this to match the damage to a person.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximums score: 12
• The higher the score the more aggressive the episode.
|
Points |
Level of Aggression |
|
0 or 1 |
none |
|
2 to 5 |
mild |
|
6 to 8 |
moderate |
|
9 to 12 |
severe |
If several episodes occur during a 60 minute period, then these are considered 1 episode, with the total score being the sum of the maximum value for each parameter.
Addition information collected:
(1) provocation (none discernible, provoked by patient, help with activities of daily living (ADL), staff demanding that patient take a medicine, patient denied something, other
(2) means used by the patient: verbal only, verbal and physical threat, hand, foot, chair, glass, teeth, strangling with hands, knife, other
(3) measure to stop aggression: none needed, talk with patient, calmly brought away, oral medication, parenteral medication, physical restraint
Specialty: Psychiatry, Emergency Medicine
ICD-10: ,
