Procedures
Data were collected from August 2012 to January
2013, and the sampling method was by convenience.
An attempt was made to include all inpatients that met
inclusion criteria in those 6 months. Some of the authors
visited the PED daily, gathered data about hospitalizations
in the last 24 hours, interviewed patients and reviewed
medical records to fill out the study form.
One of the authors was exclusively assigned to apply
the OAS scale by interviewing the patient and a family
member, as well as talking to the nursing staff and the
attending physicians. As several aggressive incidents
may be part of the same episode, which may last for
hours, we considered each 24-hour period as an episode.
Six resident physicians were responsible for filling
out the scales after interviewing the patients, which
should be done within 24 hours of admission, taking into
account patient condition at admission.
Diagnosis were assessed by the PED and PU medical
teams according to their service routines. During patient
stay in the hospital, diagnosis were discussed with
the resident´s supervisor and recorded in the chart at
discharge using the 10th revision of the International
Classification of Diseases (ICD-10). No specific diagnostic
instruments were used because of the practical difficulties
of their application, such as the time necessary to fill
in the questionnaire and the patient conditions in the
emergency department, sometimes agitated and
sometimes sedated. In addition, our purpose was not to
associate diagnosis and aggression, because diagnoses
were less important than clinical and psychopathological
characteristics in our study.
Each admission was counted separately, regardless
of how many times the patient had been admitted in
the period. The same patients may have a different
psychopathological condition each time they are
admitted, and may be either aggressive or not.
When data collection was concluded, all the forms were
reviewed. After that, data were entered into Excel by two
operators, to avoid typing errors. This study was approved
by the Research Ethics Committee of Universidade
Federal de Santa Maria and was registered in the Brazilian
Research Ethics Database (Plataforma Brasil; CAAE