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RESEARCH ARTICLE
Contents Vol 21(2)

Adapting the Client Priority Rating Scale to better fit the sexual health counselling setting: a quality improvement study

Katherine Coote https://orcid.org/0000-0002-8990-7295 A * , Fiona O’Neill B and Eve Slavich https://orcid.org/0000-0002-6520-6195 C
+ Author Affiliations
- Author Affiliations

A Sydney Sexual Health Centre, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2001, Australia.

B Sutherland Hospital Drug and Alcohol Service, Kingsway, Caringbah, NSW, Australia.

C Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW, Australia.

* Correspondence to: katherine.coote@health.nsw.gov.au

Handling Editor: Kevan Wylie

Sexual Health 21, SH23171 https://doi.org/10.1071/SH23171
Submitted: 11 October 2023  Accepted: 9 February 2024  Published: 27 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

When demand for counselling in community-based clinics exceeds capacity, waiting lists are typically formed. Determining allocation priority solely on wait time can overlook client risk factors that can elevate priority. We undertook to rigorously adapt the only existing validated counselling triage tool, to better fit the sexual health setting.

Methods

Sexual health counsellors were surveyed about aspects of client presentations that flagged increased priority. The revised Client Priority Rating Scale (CPRS-R) was created through systematic analysis and decision making, informed by survey results and literature review. Four expert sexual health counsellors independently rated the priority of 14 hypothetical clinical vignettes using the CPRS and CPRS-R.

Results

Criterion (concurrent), content and face validity are evidenced in the revised scale. Average interrater agreement was higher on the CPRS-R (28%) than the CPRS (11%); however, this difference was marginal (P = 0.06). According to Gwet’s Agreement Coefficient (AC) and Krippendorff’s Alpha, both the CPRS and the CPRS-R demonstrate comparable interrater reliability, substantial and moderate, respectively. Kendall’s W indicates the CPRS yielded higher reliability. However, the difference is not substantial.

Conclusions

The CPRS-R is a triage tool designed for the sexual health counselling setting. This tool has demonstrated criterion, content and face validity, as well as moderate to substantial inter-rater reliability. It can be used in sexual health settings to inform assessments about client priority, along with clinical judgement and peer consultation.

Keywords: clinical judgement, counselling, priority, reliability, scale, sexual health, triage, validity.

References

1  Lakeman R, Cashin A, Hurley J, Ryan T. The psychotherapeutic practice and potential of mental health nurses: an Australian survey. Aust Health Rev 2020; 44(6): 916-923.
| Crossref | Google Scholar |

2  Rossell SL, Neill E, Phillipou A, Tan EJ, Toh WL, Van Rheenen TE, Meyer D. An overview of current mental health in the general population of Australia during the COVID-19 pandemic: results from the COLLATE project. Psychiatry Res 2021; 296: 113660.
| Crossref | Google Scholar | PubMed |

3  Petrie K, Baldwin P, Crawford J, Harvey SB. The voice of mental health practice in Australia: a mixed-method cross-sectional study of gaps and areas of need. Aust N Z J Public Health 2021; 45(4): 318-324.
| Crossref | Google Scholar |

4  Nakao H, Ukai I, Kotani J. A review of the history of the origin of triage from a disaster medicine perspective. Acute Med Surg 2017; 4: 379-384.
| Crossref | Google Scholar |

5  Bengelsdorf H, Levy LE, Emerson RL, Barile FA. A crisis triage rating scale: brief dispositional assessment of patients at risk for hospitalization. J Nerv Ment Dis 1984; 172: 424-430.
| Crossref | Google Scholar |

6  Turner PM, Turner TJ. Validation of the crisis triage rating scale for psychiatric emergencies. Can J Psychiatry 1991; 36: 651-654.
| Crossref | Google Scholar |

7  Adeosun II, Adegbohun A, Akinjola O, Jejeloye A, Ajayi B, Adenusi T. Validity of the crisis triage rating scale among attendees of a psychiatric emergency department in Nigeria. Int J Ment Health Psychiatry 2017; 03: 4.
| Crossref | Google Scholar |

8  Smart D, Pollard C, Walpole B. Mental health triage in emergency medicine. Aust N Z J Psychiatry 1999; 33((1)): 57-66.
| Crossref | Google Scholar |

9  Broadbent M, Moxham L, Dwyer T. The development and use of mental health triage scales in Australia. Int J Ment Health Nurs 2007; 16(6): 413-421.
| Crossref | Google Scholar | PubMed |

10  Sands N, Elsom S, Colgate R, Haylor H, Prematunga R. Development and interrater reliability of the UK Mental Health Triage Scale. Int J Ment Health Nurs 2016; 25(4): 330-336.
| Crossref | Google Scholar |

11  Shirvington P, Innes D, Jordan C, Kuter P. Client priority rating scale. Available from the Illawarra Institute for Mental Health 2000, University of Wollongong, NSW 2522, Australia.

12  Walton CJ, Grenyer BFS. Prioritizing access to psychotherapy services: the client priority rating scale. Clin Psychol Psychother 2002; 9: 418-429.
| Crossref | Google Scholar |

13  Victorian Government Department of Health. Managing demand for community health services. Melbourne; 2009. Available at https://www.health.vic.gov.au/community-health/priority-tools-for-community-health-services

14  Nili A, Tate M, Barros A, Johnstone D. An approach for selecting and using a method of inter-coder reliability in information management research. Int J Inf Manage 2020; 54: 102154.
| Crossref | Google Scholar |

15  Gwet K. Handbook of interrater reliability. The definitive guide to measuring the extent of agreement among raters. 2010; Gaithersburg, MD: Advanced Analytics, LLC, 2.

16  Hayes AF, Krippendorff K. Answering the call for a standard reliability measure for coding data. Commun Methods Meas 2007; 1(1): 77-89.
| Crossref | Google Scholar |

17  Emerson RW. Kendall’s W and inter-rater reliability. J Vis Impair Blind 2023; 117(4): 336.
| Crossref | Google Scholar |

18  Zhao X, Liu JS, Deng K. Assumptions behind intercoder reliability indices. Ann Int Commun Assoc 2013; 36(1): 419-480.
| Crossref | Google Scholar |

19  Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174.
| Crossref | Google Scholar |

20  Smith A, Breazeale S, Goulet JL, et al. A systematic review of risk factors for suicide among persons living with HIV (1996–2020). AIDS Behav 2022; 26: 2559-2573.
| Crossref | Google Scholar |

21  Pelton M, Ciarletta M, Wisnousky H, Lazzara N, Manglani M, Ba DM, Chinchillli VM, Du P, Ssentongo AE, Ssentongo P. Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis. Gen Psychiatr 2021; 34(2): e100247.
| Crossref | Google Scholar |

22  Chen F, Cai C, Wang S, Qin Q, Jin Y, et al. Trends in suicide mortality among people with HIV after diagnosis during 2012–18: a retrospective, national cohort study in China. Lancet HIV 2022; 9(2): e102-e111.
| Crossref | Google Scholar |

23  Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide attempt as a risk factor for completed suicide: even more lethal than we knew. Am J Psychiatry 2016; 173: 1094-1100.
| Crossref | Google Scholar |

24  Beghi M, Rosenbaum JF, Cerri C, Cornaggia CM. Risk factors for fatal and nonfatal repetition of suicide attempts: a literature review. Neuropsychiatr Dis Treat 2013; 9: 1725-1736 10.2147/NDT.S40213.
| Google Scholar |

25  Semrau M, van Ommeren M, Blagescu M, Griekspoor A, Howard LM, Jordans M, Lempp H, Marini A, Pedersen J, Pilotte I, Slade M, Thornicroft G. The development and psychometric properties of the humanitarian emergency settings perceived needs (HESPER) Scale. Am J Public Health 2012; 102: e55-e63.
| Crossref | Google Scholar |

26  Oliver V, De Rantere D, Ritchie R, Chisholm J, Hecker KG, Pang DSJ. Psychometric assessment of the Rat Grimace Scale and development of an analgesic intervention score. PLoS ONE 2014; 9(5): e97882.
| Crossref | Google Scholar |

27  Hobart J, Freeman J, Thompson A. Kurtzke scales revisited: the application of psychometric methods to clinical intuition. Brain 2000; 123(5): 1027-1040.
| Crossref | Google Scholar |

28  Haynes SN, O’Brien WH. Functional psychological assessment and clinical judgment. In: Haynes SN, O’Brien WH, editors. Principles and practice of behavioral assessment. Applied Clinical Psychology. Boston, MA: Springer; 2000. pp. 41–60.

29  Bell I, Mellor D. Clinical judgements: research and practice. Aust Psychol 2009; 44: 112-121.
| Crossref | Google Scholar |

30  Shedler J, Mayman M, Manis M. The illusion of mental health. Am Psychol 1993; 48(11): 1117-1131.
| Crossref | Google Scholar |