Combination of Antipsychotic Medication and Crisis Intervention on Outcomes of Acute Mental Illness Patients Scale

Arum Pratiwi¹, Juli Muhammad Kartiko², Pupus Risnawati³, Suwito³, A Muhlisin⁴and Arif Widodo¹

¹Psychiatric Nursing Department, Faculty of Health Science Universitas Muhammadiyah Surakarta, Jl A Yani Tromol Pos I Solo,  62271 717417.

²Emergency Unit, Psychiatric Hospital of Surakarta, Jl Sutami Kentingan Jebres Solo, 622717890405.

³Acute room, Psychiatric Hospital of Surakarta, Jl Sutami Kentingan Jebres Solo, 62271648920.

⁴Community and family Nursing Department, Faculty of Health Science Universitas Muhammadiyah Surakarta, Jl A Yani Tromol Pos I Solo 62271 717417.

Corresponding Author E Mail: Arum.Pratiwi@ums.ac.id

Abstract: Background: The Crisis intervention program is very crucial to reduce the violence of emergency and acute mental illness. In the present research, an adjusted violence scale instrument through the implementation of a crisis intervention program that was combined with antipsychotic medicine was proposed for acute mental illness patients. Methods and Material: The Brøset’s violence risk scale instrument was utilized to measure the patients' behavior with intervention; after that, it was refined (mixed method with concurrent embedded strategy) to adapt the measuring scales. Each patient was given a crisis intervention program and received similar antipsychotic medication that comprised of Chlorpromazine 300 mg/day, Haloperidol 15 mg/day, and Trihexyphenidyl 6 mg/day; then, the response was recorded for 7 to 12 days in an acute inpatient psychiatric unit. The instrument was adjusted to satisfy the changes in patients' behaviors throughout an intervention. Then, a trial procedure, verification, and validation were performed on the content of the instrument. Results: The results revealed that a paired-samples t-test comparison of the panic level of 72  patients' violence was t=-7617 and probability 0.000. The proportion of agreement Cohen's kappa (κ) can range from -1 to +1. It means that the kappa (κ) equal to 0.667 represents a moderate agreement. Furthermore, since Probability was very low ( P < 0.05). Conclusions: It can be concluded that there was different levels of patients' violence  before and after the crisis intervention. The interrater statistical results confirmed that the majority of nurses had similar perceptions towards items of modified Brøset’s violence risk scales.

Keywords: Acute Psychiatric Patient; Anti-Psychotic Medication; Crisis Intervention; Violence Scale Modification

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