The development, use, and reliability of the Brief Psychiatric Rating Scale (Nursing Modification)—An assessment procedure for the nursing team in clinical and research settings

The role of nursing staff in the systematic rating of psychopathology has been explored in a small number of studies in recent years. Nurses are uniquely placed to carry out relatively continuous observations of high validity which are sensitive to change, yet on the basis of the limited data available, some doubts remain concerning the reliability of such ratings, particularly when they extend to nonobservational phenomena. Nevertheless, since in practice nurse ratings form an important part of the psychopathological assessment arm in many research settings, continuing uncertainty about their reliability is clearly undesirable. Following a brief review of nurse rating, this report describes the role of the nursing team in a developing research environment and reports interrater reliability data for randomly selected pairings of nurses drawn from a mainstream clinical team who had been trained in the use of a specially modified version of the Brief Psychiatric Rating Scale (Nursing Modification) (BPRS[NM]). The findings indicate that nursing staff can reliably rate this range of psychopathology under ordinary clinical conditions, provided they have been properly trained and that appropriate modifications have been made to the procedure. Although validity was not formally assessed in this study, the extension of the time period covered by the BPRS, combined with the special place of nurses in the ward milieu can also be expected to enhance the validity and sensitivity of the ratings. Other effects of the involvement of therapeutically-oriented nursing staff in research procedures are also discussed.