THE TESTING OF INSTRUMENTS TO MEASURE RULES, ROLE INCOMPETENCE AND VIOLENCE IN PSYCHIATRIC INPATIENTS.

The purpose of this study was to test research instruments to measure social and therapeutic rules, role incompetence and violence in hospitalized psychiatric patients. Instruments were tested to measure the specific concepts of: the Discrepant Interpretation of the Therapeutic Rules (GTRS and PTRSI), the Inconsistent Enforcement of the Social Rules (SRSI), the patients' Inability to Adhere to the Therapeutic Rules (PTRSII), the patients' Inability to Adhere to the Social Rules (SRSII) and Violence (VS). The study used a descriptive correlational design. The nursing staff sample consisted of 57 nursing staff working in nine clinical psychiatric units of four local hospitals. The nursing staff sample completed research ratings on 162 patient subjects hospitalized on the units. The data were analyzed for estimations of the psychometric properties of the research instruments. The theory was estimated using correlational and multiple regression techniques. The results indicated that with the exception of the General Therapeutic Rule Scale, the instruments had strong evidence of reliability and validity. The General Therapeutic Rule Scale had limited evidence of reliability and validity. The theoretical model testing indicated that three of the predicted theoretical relationships were supported. The expanded empirical model testing indicated three additional relationships. The amount of variance in violence explained by the expanded empirical model was R² = 18%. The major findings of this study were: (a) the social rules were more important than the therapeutic rules in predicting violence, (b) contrary to the literature, personal patient variables such as, age, sex, and diagnosis did not contribute to violence in the hospital setting, (c) a patient history of violence outside the hospital contributed to the patients' inability to adhere to the rules, (d) a direct relationship existed between the therapeutic and social rules, (e) the subdimensions of violence against self, others and property may be theoretically distinct dimensions of violence, and (f) the relationship of violence and other variables may be curvilinear