The SOAS-R is an easy-to-use instrument that helps documenting a wide range of aggressive behaviours.
SOAS-R, stands for The Staff Observation Aggression Scale – Revised. With this instrument caregivers can quickly document what exactly happened during aggressive occurrences as the answer options in the instrument’s five columns only have to be marked by the ward staff. It gives a better insight of when and why patients and clients are most likely to engage in aggressive behaviour, to intervene effectively and to prevent an increase of aggression.
Request more about SOAS-RThe SOAS‐R is a tool for monitoring a wide range of (self‐) destructive acts, which allows for better policies that will result in less aggression.
Proper assessment of aggressive behavior is essential for an understanding of its causes. The most important reason all agressive incidents should be reported is to allow arrangements for prompt measures. Oftentimes aggressive incidents result from minor aggressive incidents that cannot be prevented if care is untimely, therefore reporting incidents when they occur is so important. Another equally important reason to report all agressive incidents is that they must be investigated and their causes found, to prevent the same from happening again to someone else. The SOAS-R is an instrument for monitoring the frequency, nature, and severity of aggressive incidents. The use of the SOAS-R will help get better insight in why and when aggression occurs after which policies can be adjusted in order to reduce violence.
RequestSOAS-R module within the Re-Act Software
- Installation software included
- Various complex analyses on multi-company levels (Patient, unit, organizational)
- Possibility to expand with multiple modules
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SOAS-R integration in third party software
- Third party is responsible for integration
- Look and feel after own preference
- Pay per use, BVC only
- Assistance with integration in third party software
Customers who use the SOAS-R wisely
Meet the author of the SOAS-R Method.
Prof. dr. Tom Palmstierna
Tom Palmstierna is a senior psychiatrist at the Stockholm Addiction Centre in Sweden, and associate professor at the institute for Clinical Neuroscience at the Karolinska Institute in Stockholm, Sweden. Besides that, Tom Palmstierna is professor at the faculty of medicine of the Norwegian University of Technology and Science, and a senior researcher of the Forensic psychiatric research group at the Bröset forensic psychiatric hospital in Trondheim, Norway.
Prof. dr. Henk Nijman
Henk Nijman was professor of forensic psychology at the Radboud University in Nijmegen, the Netherlands and senior researcher at the forensic psychiatric institution Fivoor. Before his appointment at Radboud University, he was a visiting professor at the department of Mental Health and Learning Disability of City University in London. He obtained his master in mental Health Sciences from Maastricht University in 1992 and in 1999 received a PhD from the faculty of psychology at the same university for his dissertation entitled: Aggressive Behaviour of psychiatric inpatients; Measurement, prevalence and determinants. His main research areas are the causes and prevention of violent behavior of (forensic) psychiatric patients and patients with (mild) intellectual disabilities. He has written numerous peer reviewed articles and book chapters on this topic. Together with professor dr. Tom Palmstierna he revised and tested the SOAS-R.
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Frequently Asked Questions
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What is the use of recording aggressive incidents with the SOAS-R?
Data on aggressive incidents that occurred in the past, provide opportunities to enhance safety on the wards by searching for patterns in the occurrence of aggression with the aim of developing preventive strategies. A way to ensure attention is continually given to safety on the ward is to put the SOAS-R registrations on the agenda of the regular team meetings (for example, once a week or every two weeks). The SOAS-R software from Frenzs provides a great number of options to make graphs and tables concerning the aggressive incidents that have take place in any given period.
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The SOAS-R has to be completed each time a staff member witnesses aggressive behavior of a patient. In case two or more staff members witness the same aggressive incident, should each of them complete a SOAS-R form?
No, only one SOAS-R form has to be completed for each incident. In case multiple staff members witness the same incident, they can complete the form together, or one of the staff members can complete one SOAS-R form on behalf of all of them.
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Can the SOAS-R also be used to register auto-aggressive behavior and selfharming acts of patients?
Yes, Aggressive behaviour which the patient directs at himself or herself (for example, self-inflicted injuries) can also be registered with the SOAS-R.
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Is it allowed to mark more than one of the answering options of each of the five the SOAS-R columns?
Yes, in each of the five SOAS-R columns at least one of the answering options needs to be endorsed, but it is allowed, and often necessary, to mark more than one of the answering options in a column of the SOAS-R. So yes, using more than one answer per column is permitted.
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In which cases does the SOAS-R have to be completed? Is there some definition that helps staff members to decide when a form has to be completed?
The following definition of aggressive behaviour derived from Morrison (1990) is used to define which types of behaviours should be recorded with the SOAS-R:
“Aggressive behaviour is any verbal, non-verbal or physical behaviour that was threatening (to self, others or property), or physical behaviour that actually did harm (to self, others, or property)”.
This definition of aggressive behaviour shows, that both verbal and physical aggression against individuals and objects are expected to be registered, as well as aggression which the patient directs to itself.
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When should the SOAS-R form(s) be completed? At the end of each shift?
Try to complete the SOAS-R form as soon as possible after any aggressive behavior took place (as soon as it safe to do so). Don’t wait till the end of the shift, but complete a form directly after each incident. This ensures that no incidents, and no information, will be missed in the database.
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What we see now is that mostly the SOAS-R is used in psychiatry and in facilities for mentally desabled persons and even in youth care. Can you think of other sectors in which the SOAS-R could possibly work as well?
The SOAS and the SOAS-R was originally used in emergency psychiatiatric inpatient care and geriatric institutions. In addition, it is also used in forensic psychiatric institutions as well as institutions for substance users. There are now adaptions for the care for clients with intellectual disabilities, social services, primary and emergency healthcare available. Basically the framework of the SOAS-R (the five column structure) can be used in any sector in a way, oftentimes some adjustments are to be made by the authors of the SOAS-R. There is also a version being used in a large warehouse of Delhaize in Belgium. The possibilities are endless. If you have special requests on different contexts and locations, please contact the authors.
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Roel Ruiken
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