A new paradigm of injury intentionality

Objective—To improve understanding of processes leading to injury and assess more specifically the degree of intentionality. Methods—A new paradigm was developed that characterizes the act of inflicting injury (self, other, not inflicted) and the motive. Motives are determined for the act of injury...

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Bibliographic Details
Published in:Injury prevention 1999-03, Vol.5 (1), p.59-61
Main Authors: Cheng, Tina L, Wright, Joseph L, Fields, Cheryl B, Brenner, Ruth A, Schwarz, Donald, O'Donnell, Regina, Scheidt, Peter C
Format: Article
Language:English
Subjects:
Adolescent
Child
Classification
Codes
Firearms
Humans
Injuries
injury coding
intentionality
Methodologic Issues
Morbidity
Mortality
Motivation
Murders & murder attempts
Personal protective equipment
Prevention
Reproducibility of Results
Sports injuries
Sports related injuries
Suicides & suicide attempts
Violence
Wounds and Injuries - classification
Wounds and Injuries - prevention & control
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Summary:Objective—To improve understanding of processes leading to injury and assess more specifically the degree of intentionality. Methods—A new paradigm was developed that characterizes the act of inflicting injury (self, other, not inflicted) and the motive. Motives are determined for the act of injury and for the outcome. To test this, 986 cases of adolescent injuries in seven hospitals were reviewed. Three investigators independently classified all cases using the new paradigm and three used standard definitions of intent. Inter-rater reliability was measured. Results—Of injuries inflicted by others, 61% were intentional using the standard classification. In the new paradigm 67% were intended acts and 59% involved intentional motive for outcome. Altogether 87% of sports injuries were coded as unintentional acts compared with 96% using standard methods. Using standard classification there was 93% agreement between paired raters, with an average κ of 0.86. In the new paradigm questions on intentionality of act, outcome, and infliction of act, the agreement was 89%, 91%, 88%, with a κ of 0.79, 0.80, 0.76, respectively. Conclusions—This paradigm defines a spectrum of injury intent, enhances understanding of the causal sequence of injury, and has important implications for research and prevention.
ISSN:1353-8047
1475-5785
DOI:10.1136/ip.5.1.59